| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.66 | $21.66 | $21.66 | |
Aetna
| Professional | $20.38 | $21.66 | $21.91 | |
Cigna
| Professional | $11.90 | $11.90 | $11.90 | |
Moda Health
| Facility | $12.60 | $21.91 | $28.04 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |