| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $236.95 | $236.95 | $236.95 | |
Cigna
| Facility | $170.15 | $170.15 | $170.15 | |
Cigna
| Professional | $124.21 | $170.15 | $181.39 | |
Moda Health
| Facility | $65.75 | $65.75 | $65.75 | |
Moda Health
| Professional | $211.73 | $257.06 | $405.89 | |
Providence
| Facility | $65.75 | $65.75 | $170.15 | |
Providence
| Professional | $124.21 | $170.15 | $259.08 | |
United
| Professional | $130.78 | $134.99 | $258.74 |