| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.00 | $15.00 | $15.00 | |
Cigna
| Professional | $1.68 | $1.68 | $1.68 | |
Moda Health
| Facility | $15.00 | $15.00 | $43.50 | |
Providence
| Facility | $15.00 | $15.00 | $43.50 | |
Providence
| Professional | $1.68 | $1.68 | $1,800,000.00 |