| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $346.74 | $346.74 | $346.74 | |
Cigna
| Professional | $6.92 | $1,122.02 | $1,202.26 | |
Moda Health
| Facility | $0.52 | $0.52 | $346.74 | |
Moda Health
| Professional | $60.26 | $60.26 | $346.74 | |
Providence
| Facility | $0.52 | $0.52 | $0.78 | |
Providence
| Professional | $58.88 | $60.26 | $1,202.26 |