| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.48 | $248.48 | $248.48 | |
Aetna
| Professional | $248.48 | $278.92 | $555.63 | |
Cigna
| Facility | $256.50 | $256.50 | $256.50 | |
Cigna
| Professional | $35.83 | $256.50 | $264.20 | |
Moda Health
| Facility | $172.89 | $237.24 | $419.43 | |
Molina
| Professional | $29.09 | $56.29 | $415.42 | |
United
| Professional | $183.19 | $212.60 | $391.76 |