| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $43.22 | $43.22 | $43.22 | |
Cigna
| Professional | $14.86 | $14.86 | $14.86 | |
Moda Health
| Facility | $35.28 | $37.39 | $43.22 | |
Providence
| Facility | $35.28 | $37.39 | $43.22 | |
Providence
| Professional | $14.86 | $14.86 | $14.86 |