| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $158.80 | $158.80 | $158.80 | |
Cigna
| Facility | $100.43 | $100.43 | $100.43 | |
Cigna
| Professional | $73.31 | $100.43 | $107.06 | |
Moda Health
| Facility | $46.76 | $46.76 | $46.76 | |
Moda Health
| Professional | $137.91 | $176.10 | $278.06 | |
Providence
| Facility | $46.76 | $46.76 | $100.43 | |
Providence
| Professional | $73.31 | $107.06 | $170.12 | |
United
| Professional | $89.60 | $177.25 | $231.20 |