| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $193.01 | $193.01 | $193.01 | |
Aetna
| Professional | $193.01 | $238.98 | $238.98 | |
Cigna
| Facility | $180.13 | $180.13 | $180.13 | |
Cigna
| Professional | $153.11 | $180.13 | $307.80 | |
Moda Health
| Facility | $202.33 | $238.98 | $287.22 | |
Molina
| Professional | $55.00 | $55.00 | $55.00 |