| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $132.16 | $132.16 | $132.16 | |
Cigna
| Facility | $100.03 | $100.03 | $100.03 | |
Cigna
| Professional | $73.02 | $100.03 | $106.64 | |
Moda Health
| Facility | $44.49 | $44.49 | $44.49 | |
Moda Health
| Professional | $143.37 | $143.37 | $226.38 | |
Providence
| Facility | $44.49 | $44.49 | $100.03 | |
Providence
| Professional | $73.02 | $106.64 | $148.80 | |
United
| Professional | $72.94 | $75.29 | $144.31 |