| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $176.55 | $176.55 | $176.55 | |
Aetna
| Professional | $141.24 | $150.07 | $176.55 | |
Moda Health
| Facility | $140.21 | $151.83 | $217.12 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
United
| Professional | $136.80 | $136.80 | $191.52 |