| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $535.54 | $535.54 | $535.54 | |
Cigna
| Facility | $335.84 | $335.84 | $335.84 | |
Cigna
| Professional | $245.16 | $245.16 | $245.16 | |
Moda Health
| Facility | $143.40 | $143.40 | $143.40 | |
Moda Health
| Professional | $563.96 | $581.01 | $917.39 | |
Providence
| Facility | $143.40 | $143.40 | $335.84 | |
Providence
| Professional | $245.16 | $440.27 | $695.66 | |
United
| Professional | $305.11 | $305.11 | $584.79 |