| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $130.51 | $130.51 | $142.26 | |
Aetna
| Professional | $110.15 | $142.26 | $142.26 | |
Cigna
| Professional | $66.00 | $66.00 | $66.00 | |
Moda Health
| Facility | $130.51 | $142.26 | $156.49 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 |