| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $884.17 | $884.17 | $884.17 | |
Cigna
| Facility | $408.60 | $408.60 | $408.60 | |
Cigna
| Professional | $298.27 | $408.60 | $435.59 | |
Moda Health
| Facility | $210.61 | $210.61 | $210.61 | |
Moda Health
| Professional | $635.27 | $980.53 | $1,548.21 | |
Providence
| Facility | $210.61 | $210.61 | $408.60 | |
Providence
| Professional | $298.27 | $435.59 | $783.65 | |
United
| Professional | $498.86 | $772.38 | $1,287.30 |