| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.24 | $21.24 | $21.24 | |
Cigna
| Professional | $228.00 | $228.00 | $228.00 | |
Moda Health
| Facility | $8.00 | $21.24 | $60.00 | |
Molina
| Professional | $1,500.00 | $1,500.00 | $1,500.00 |