| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.34 | $11.34 | $11.34 | |
Aetna
| Professional | $11.34 | $11.34 | $11.34 | |
Moda Health
| Facility | $11.34 | $12.02 | $54.28 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
United
| Professional | $26.37 | $32.40 | $45.98 |