| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $252.02 | $252.02 | $252.02 | |
Cigna
| Facility | $190.78 | $190.78 | $190.78 | |
Cigna
| Professional | $139.27 | $190.78 | $203.38 | |
Moda Health
| Facility | $84.01 | $84.01 | $84.01 | |
Moda Health
| Professional | $247.80 | $279.49 | $441.30 | |
Providence
| Facility | $84.01 | $84.01 | $190.78 | |
Providence
| Professional | $139.27 | $193.46 | $289.69 | |
United
| Professional | $142.19 | $281.31 | $366.93 |