| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $155.00 | $200.81 | $200.81 | |
Aetna
| Professional | $155.00 | $180.89 | $219.05 | |
Cigna
| Professional | $45.05 | $45.05 | $45.05 | |
Moda Health
| Facility | $155.00 | $178.48 | $219.47 | |
Molina
| Professional | $1,500.00 | $1,500.00 | $3,500.00 |