| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $18.84 | $21.43 | $25.79 | |
Cigna
| Professional | $22.28 | $22.28 | $22.28 | |
Moda Health
| Facility | $18.05 | $21.43 | $32.14 | |
Moda Health
| Professional | $54.73 | $54.73 | $54.73 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 |