| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $208.99 | $228.74 | $228.74 | |
Cigna
| Facility | $195.78 | $195.78 | $195.78 | |
Cigna
| Professional | $166.41 | $166.41 | $166.41 | |
Moda Health
| Facility | $76.44 | $76.44 | $76.44 | |
Moda Health
| Professional | $254.69 | $254.69 | $254.69 | |
Providence
| Facility | $76.44 | $76.44 | $195.78 | |
Providence
| Professional | $166.41 | $198.84 | $314.17 | |
United
| Professional | $152.94 | $157.87 | $302.58 |