| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.28 | $29.28 | $29.28 | |
Aetna
| Professional | $20.83 | $20.83 | $29.28 | |
Cigna
| Facility | $70.00 | $70.00 | $75.00 | |
Moda Health
| Facility | $20.83 | $20.83 | $26.66 | |
Molina
| Professional | $30.00 | $30.00 | $2,000.00 |