| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.17 | $15.17 | $15.17 | |
Cigna
| Facility | $16.64 | $16.64 | $16.64 | |
Cigna
| Professional | $16.64 | $16.64 | $16.64 | |
Moda Health
| Facility | $15.17 | $16.07 | $21.69 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
United
| Professional | $17.30 | $18.38 | $23.60 |