| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.23 | $19.23 | $67.97 | |
Aetna
| Professional | $11.95 | $19.42 | $19.42 | |
Moda Health
| Facility | $27.77 | $27.77 | $27.77 | |
Moda Health
| Professional | $9.31 | $9.31 | $13.30 | |
Providence
| Facility | $27.77 | $27.77 | $27.77 | |
United
| Professional | $16.13 | $21.60 | $43.20 |