| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $457.73 | $457.73 | $457.73 | |
Cigna
| Professional | $457.73 | $457.73 | $457.73 | |
Moda Health
| Facility | $504.10 | $504.10 | $504.10 | |
Moda Health
| Professional | $526.39 | $526.39 | $526.39 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
United
| Professional | $518.17 | $518.17 | $721.46 |