| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $10.00 | $12.59 | |
Cigna
| Professional | $4.79 | $4.79 | $4.79 | |
Moda Health
| Facility | $7.94 | $7.94 | $7.94 | |
Moda Health
| Professional | $10.00 | $10.00 | $10.00 | |
Providence
| Facility | $7.94 | $7.94 | $7.94 | |
Providence
| Professional | $2.88 | $2.88 | $2.88 |