| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $457.09 | $457.09 | $1,862.09 | |
Aetna
| Professional | $316.23 | $316.23 | $446.68 | |
Cigna
| Professional | $52.48 | $52.48 | $52.48 | |
Moda Health
| Facility | $316.23 | $436.52 | $1,778.28 | |
Moda Health
| Professional | $79.43 | $316.23 | $436.52 | |
Providence
| Facility | $316.23 | $316.23 | $457.09 | |
Providence
| Professional | $30.90 | $30.90 | $79.43 |