| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $520.09 | $520.09 | $520.09 | |
Cigna
| Facility | $253.20 | $253.20 | $253.20 | |
Cigna
| Professional | $184.84 | $253.20 | $260.80 | |
Moda Health
| Facility | $130.51 | $130.51 | $130.51 | |
Moda Health
| Professional | $443.77 | $576.77 | $910.70 | |
Providence
| Facility | $130.51 | $130.51 | $253.20 | |
Providence
| Professional | $184.84 | $260.80 | $514.25 | |
United
| Professional | $293.44 | $580.54 | $757.23 |