| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.68 | $12.68 | $12.68 | |
Aetna
| Professional | $12.68 | $12.68 | $27.50 | |
Cigna
| Professional | $8.50 | $8.50 | $8.50 | |
Moda Health
| Facility | $10.00 | $18.30 | $18.30 | |
Molina
| Professional | $30.00 | $78.00 | $3,900.00 |