| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.27 | $19.27 | $19.27 | |
Cigna
| Professional | $68.79 | $68.79 | $68.79 | |
Moda Health
| Facility | $9.39 | $19.27 | $56.66 | |
Molina
| Professional | $1,500.00 | $1,500.00 | $1,500.00 |