| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.48 | $71.48 | $252.70 | |
Aetna
| Professional | $44.39 | $72.20 | $72.20 | |
Cigna
| Professional | $45.46 | $45.46 | $45.46 | |
Moda Health
| Facility | $103.25 | $103.25 | $103.25 | |
Providence
| Facility | $103.25 | $103.25 | $103.25 | |
Providence
| Professional | $45.46 | $45.46 | $45.46 |