| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.15 | $67.15 | $67.15 | |
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $26.11 | $30.72 | $31.64 | |
Moda Health
| Facility | $67.15 | $67.15 | $80.83 | |
Providence
| Facility | $58.88 | $67.15 | $80.83 | |
Providence
| Professional | $26.11 | $30.72 | $31.64 |