| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.00 | $8.00 | $8.00 | |
Aetna
| Professional | $8.00 | $157.00 | $157.00 | |
Cigna
| Professional | $24.99 | $24.99 | $24.99 | |
Moda Health
| Facility | $157.00 | $157.00 | $200.96 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 |