| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.16 | $67.16 | $73.87 | |
Cigna
| Facility | $74.02 | $74.02 | $74.02 | |
Cigna
| Professional | $74.02 | $74.02 | $74.02 | |
Moda Health
| Facility | $11.82 | $67.16 | $96.04 | |
Moda Health
| Professional | $28.71 | $28.71 | $28.71 | |
United
| Professional | $74.68 | $79.31 | $79.31 |