| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $166.12 | $176.96 | $227.23 | |
Cigna
| Professional | $184.50 | $184.50 | $184.50 | |
Lucent Health
| Professional | $1,338.62 | $1,338.62 | $1,683.30 | |
Moda Health
| Professional | $220.61 | $260.72 | $360.99 | |
Providence
| Professional | $184.50 | $184.50 | $191.21 | |
United
| Professional | $169.71 | $236.50 | $343.95 | |
Wellpoint
| Professional | $171.16 | $196.71 | $271.93 |