| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $155.18 | $155.18 | $237.75 | |
Aetna
| Professional | $117.95 | $237.75 | $237.75 | |
Moda Health
| Facility | $155.18 | $237.75 | $304.32 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 |