| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.25 | $776.25 | $776.25 | |
Aetna
| Professional | $134.90 | $138.04 | $218.78 | |
Cigna
| Professional | $138.04 | $138.04 | $138.04 | |
Moda Health
| Facility | $218.78 | $316.23 | $776.25 | |
Moda Health
| Professional | $60.26 | $128.82 | $218.78 | |
Providence
| Facility | $218.78 | $218.78 | $316.23 | |
Providence
| Professional | $60.26 | $109.65 | $154.88 | |
United
| Professional | $199.53 | $501.19 | $676.08 |