| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $133.25 | $133.25 | $133.25 | |
Cigna
| Facility | $88.96 | $88.96 | $88.96 | |
Cigna
| Professional | $64.94 | $88.96 | $91.63 | |
Moda Health
| Facility | $45.85 | $45.85 | $45.85 | |
Moda Health
| Professional | $147.77 | $147.77 | $233.33 | |
Providence
| Facility | $45.85 | $45.85 | $88.96 | |
Providence
| Professional | $64.94 | $91.63 | $153.34 | |
United
| Professional | $75.18 | $148.72 | $194.00 |