| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.95 | $19.95 | $19.95 | |
Aetna
| Professional | $19.95 | $19.95 | $19.95 | |
BCBS
| Professional | $3.16 | $3.16 | $3.16 | |
Moda Health
| Facility | $19.95 | $19.95 | $31.62 | |
Moda Health
| Professional | $19.95 | $19.95 | $19.95 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
Select Health
| Professional | $2.34 | $2.82 | $3.39 |