| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $281.30 | $343.15 | $1,286.52 | |
Aetna
| Professional | $102.14 | $121.70 | $178.45 | |
Cigna
| Professional | $119.90 | $119.90 | $119.90 | |
Moda Health
| Facility | $146.06 | $146.06 | $531.62 | |
Providence
| Facility | $146.06 | $146.06 | $146.06 | |
Providence
| Professional | $119.90 | $119.90 | $119.90 |