| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $25.12 | $25.12 | |
BCBS
| Facility | $17.78 | $22.91 | $25.70 | |
Moda Health
| Facility | $25.12 | $25.12 | $912.01 | |
Molina
| Professional | $30.20 | $30.20 | $77.62 | |
United
| Professional | $67.61 | $67.61 | $67.61 |