| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.12 | $21.12 | $28.80 | |
Cigna
| Professional | $11.89 | $11.89 | $11.89 | |
Moda Health
| Facility | $41.18 | $41.18 | $41.18 | |
Moda Health
| Professional | $16.96 | $16.96 | $24.23 | |
Providence
| Facility | $41.18 | $41.18 | $41.18 | |
Providence
| Professional | $11.89 | $11.89 | $24.23 | |
United
| Professional | $25.74 | $25.74 | $26.18 |