| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $89.57 | $89.57 | $89.57 | |
Cigna
| Facility | $75.05 | $75.05 | $75.05 | |
Cigna
| Professional | $54.79 | $54.79 | $54.79 | |
Moda Health
| Facility | $44.33 | $44.33 | $44.33 | |
Moda Health
| Professional | $88.78 | $88.78 | $126.83 | |
Providence
| Facility | $44.33 | $44.33 | $75.05 | |
Providence
| Professional | $54.79 | $54.79 | $126.83 | |
United
| Professional | $64.64 | $123.89 | $161.60 |