| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.60 | $29.60 | $148.56 | |
Aetna
| Professional | $23.68 | $23.68 | $23.68 | |
Cigna
| Professional | $75.72 | $75.72 | $75.72 | |
Moda Health
| Facility | $8.00 | $8.00 | $8.00 | |
Providence
| Facility | $8.00 | $8.00 | $8.00 | |
Providence
| Professional | $75.72 | $75.72 | $75.72 |