| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.00 | $173.00 | $173.00 | |
Aetna
| Professional | $173.00 | $173.00 | $173.00 | |
Cigna
| Facility | $263.02 | $263.02 | $263.02 | |
Cigna
| Professional | $192.01 | $192.01 | $263.02 | |
Moda Health
| Facility | $173.00 | $173.00 | $183.38 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |