| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.74 | $446.74 | $446.74 | |
Aetna
| Professional | $412.99 | $412.99 | $446.74 | |
Cigna
| Facility | $296.00 | $296.00 | $296.00 | |
Cigna
| Professional | $251.60 | $251.60 | $296.00 | |
Moda Health
| Facility | $240.80 | $412.99 | $429.68 | |
Molina
| Professional | $55.00 | $55.00 | $55.00 |