| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.43 | $36.89 | $36.89 | |
Aetna
| Professional | $7.12 | $10.54 | $10.54 | |
Cigna
| Professional | $4.82 | $4.82 | $4.82 | |
Moda Health
| Facility | $6.64 | $6.64 | $6.64 | |
Providence
| Facility | $6.64 | $6.64 | $6.64 | |
Providence
| Professional | $4.82 | $4.82 | $4.82 | |
United
| Professional | $0.03 | $0.03 | $0.06 |