| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.84 | $22.84 | $22.84 | |
Aetna
| Professional | $17.66 | $17.66 | $48.00 | |
Cigna
| Professional | $19.50 | $19.50 | $19.50 | |
Moda Health
| Facility | $17.66 | $17.66 | $48.00 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |