| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $5.00 | $5.00 | |
Cigna
| Facility | $4.12 | $4.12 | $4.12 | |
Cigna
| Professional | $3.50 | $4.12 | $4.24 | |
Moda Health
| Facility | $6.47 | $6.47 | $6.47 | |
Providence
| Facility | $5.00 | $6.47 | $6.47 | |
Providence
| Professional | $3.50 | $4.12 | $4.24 |