| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $130.79 | $130.79 | $130.79 | |
Aetna
| Professional | $118.13 | $130.08 | $130.79 | |
Cigna
| Professional | $13.17 | $13.17 | $13.17 | |
Moda Health
| Facility | $130.08 | $130.79 | $166.50 | |
Moda Health
| Professional | $119.78 | $119.78 | $119.78 | |
Molina
| Professional | $30.00 | $30.00 | $3,500.00 |