| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $896.80 | $896.80 | $896.80 | |
Aetna
| Professional | $640.32 | $896.80 | $1,479.17 | |
Cigna
| Professional | $71.76 | $71.76 | $71.76 | |
Moda Health
| Facility | $89.68 | $752.61 | $1,479.17 | |
Moda Health
| Professional | $92.08 | $245.15 | $245.15 | |
Molina
| Professional | $30.00 | $148.03 | $1,292.54 | |
United
| Professional | $60.85 | $80.83 | $178.24 |