| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $527.24 | $527.24 | $527.24 | |
Cigna
| Facility | $380.61 | $380.61 | $380.61 | |
Cigna
| Professional | $277.85 | $277.85 | $277.85 | |
Moda Health
| Facility | $172.87 | $172.87 | $172.87 | |
Moda Health
| Professional | $564.34 | $584.71 | $923.22 | |
Providence
| Facility | $172.87 | $172.87 | $380.61 | |
Providence
| Professional | $277.85 | $440.58 | $696.14 | |
United
| Professional | $297.48 | $588.52 | $767.64 |