| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $24.95 | $37.42 | $37.42 | |
Cigna
| Professional | $27.68 | $27.68 | $27.68 | |
Moda Health
| Facility | $53.51 | $53.51 | $53.51 | |
Moda Health
| Professional | $19.95 | $19.95 | $28.50 | |
Providence
| Facility | $53.51 | $53.51 | $53.51 | |
Providence
| Professional | $19.95 | $27.68 | $28.50 | |
United
| Professional | $29.35 | $29.35 | $29.85 |