| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.00 | $45.00 | $450.00 | |
Aetna
| Professional | $45.00 | $450.00 | $450.00 | |
Cigna
| Professional | $258.52 | $258.52 | $258.52 | |
Moda Health
| Facility | $450.00 | $450.00 | $576.00 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |