| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $36.50 | $114.35 | $150.94 | |
Cigna
| Facility | $70.80 | $70.80 | $70.80 | |
Cigna
| Professional | $51.68 | $51.68 | $51.68 | |
Moda Health
| Facility | $36.50 | $36.50 | $36.50 | |
Moda Health
| Professional | $107.64 | $126.82 | $200.24 | |
Providence
| Facility | $36.50 | $36.50 | $70.80 | |
Providence
| Professional | $51.68 | $84.03 | $156.43 | |
United
| Professional | $64.52 | $127.65 | $166.50 |