| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.62 | $5.62 | $5.62 | |
Aetna
| Professional | $4.50 | $4.78 | $5.62 | |
Cigna
| Facility | $4.49 | $4.49 | $4.49 | |
Cigna
| Professional | $4.49 | $4.49 | $4.49 | |
Moda Health
| Facility | $4.78 | $5.12 | $6.91 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
United
| Professional | $5.62 | $5.62 | $5.62 |