| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $145.00 | $145.00 | $145.00 | |
Aetna
| Professional | $116.00 | $124.70 | $145.00 | |
Cigna
| Professional | $80.54 | $80.54 | $80.54 | |
Moda Health
| Facility | $54.00 | $124.70 | $159.62 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |