| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.05 | $19.05 | $19.50 | |
Moda Health
| Facility | $19.50 | $19.50 | $32.36 | |
Moda Health
| Professional | $15.14 | $19.05 | $60.26 | |
Providence
| Facility | $19.50 | $19.50 | $32.36 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |