| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $284.42 | $284.42 | $284.42 | |
Cigna
| Professional | $306.00 | $306.00 | $306.00 | |
Moda Health
| Facility | $406.72 | $406.72 | $406.72 | |
Moda Health
| Professional | $243.39 | $243.39 | $347.70 | |
Providence
| Facility | $406.72 | $406.72 | $406.72 | |
Providence
| Professional | $243.39 | $306.00 | $347.70 | |
United
| Professional | $300.00 | $450.00 | $605.16 |