| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.57 | $1.57 | $1.57 | |
Aetna
| Professional | $1.57 | $1.57 | $10.93 | |
Cigna
| Professional | $10.60 | $10.60 | $10.60 | |
Moda Health
| Facility | $1.57 | $24.00 | $42.42 | |
Molina
| Professional | $30.00 | $42.00 | $3,500.00 | |
United
| Professional | $25.20 | $31.92 | $44.42 |