| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $143.04 | $151.97 | $153.77 | |
Cigna
| Facility | $151.97 | $151.97 | $151.97 | |
Cigna
| Professional | $151.97 | $151.97 | $151.97 | |
Moda Health
| Facility | $151.97 | $163.00 | $219.89 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 |