| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $129.43 | $129.43 | $129.43 | |
Cigna
| Facility | $98.15 | $98.15 | $98.15 | |
Cigna
| Professional | $71.65 | $98.15 | $104.64 | |
Moda Health
| Facility | $43.56 | $43.56 | $43.56 | |
Moda Health
| Professional | $140.41 | $140.41 | $221.72 | |
Providence
| Facility | $43.56 | $43.56 | $98.15 | |
Providence
| Professional | $71.65 | $104.64 | $145.69 | |
United
| Professional | $71.44 | $73.73 | $141.34 |