| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.47 | $25.47 | $43.54 | |
Cigna
| Professional | $155.19 | $155.19 | $155.19 | |
Moda Health
| Facility | $25.47 | $25.47 | $43.54 | |
Molina
| Professional | $1,500.00 | $1,500.00 | $1,500.00 |