| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $114.73 | $114.73 | $114.73 | |
Cigna
| Professional | $1.62 | $1.62 | $1.62 | |
Moda Health
| Facility | $114.73 | $114.73 | $332.72 | |
Providence
| Facility | $114.73 | $114.73 | $332.72 | |
Providence
| Professional | $1.62 | $1.62 | $1,800,000.00 |