| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $24.46 | $24.46 | $24.46 | |
Cigna
| Professional | $58.98 | $58.98 | $58.98 | |
Moda Health
| Facility | $8.00 | $8.00 | $24.46 | |
Molina
| Professional | $1,500.00 | $1,500.00 | $1,500.00 |