| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.59 | $16.59 | $16.59 | |
Aetna
| Professional | $16.59 | $16.59 | $16.59 | |
Moda Health
| Facility | $16.59 | $17.59 | $23.72 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
United
| Professional | $34.08 | $38.86 | $38.86 |