| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.82 | $14.82 | $14.82 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 | |
Moda Health
| Facility | $21.19 | $21.19 | $21.19 | |
Providence
| Facility | $20.30 | $20.30 | $21.19 | |
Providence
| Professional | $130.77 | $130.77 | $130.77 |