| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.56 | $48.56 | $48.56 | |
Aetna
| Professional | $45.70 | $48.56 | $49.13 | |
Cigna
| Facility | $48.56 | $48.56 | $48.56 | |
Cigna
| Professional | $48.56 | $48.56 | $48.56 | |
Moda Health
| Facility | $47.42 | $51.59 | $147.22 | |
Molina
| Professional | $30.00 | $147.22 | $287.08 | |
United
| Professional | $57.13 | $57.13 | $57.13 |