| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $154.88 | $154.88 | $234.42 | |
Aetna
| Professional | $131.83 | $234.42 | $309.03 | |
Moda Health
| Facility | $154.88 | $239.88 | $446.68 | |
Moda Health
| Professional | $117.49 | $234.42 | $446.68 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |