| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $176.26 | $176.26 | $176.26 | |
Cigna
| Facility | $147.05 | $147.05 | $147.05 | |
Cigna
| Professional | $107.35 | $107.35 | $107.35 | |
Moda Health
| Facility | $60.43 | $60.43 | $60.43 | |
Moda Health
| Professional | $195.46 | $201.02 | $308.63 | |
Providence
| Facility | $60.43 | $60.43 | $147.05 | |
Providence
| Professional | $107.35 | $156.93 | $241.12 | |
United
| Professional | $99.45 | $167.77 | $256.64 |