| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.70 | $30.00 | $48.60 | |
Aetna
| Professional | $1.10 | $2.94 | $2.94 | |
Cigna
| Professional | $10.81 | $10.81 | $10.81 | |
Moda Health
| Facility | $4.20 | $4.20 | $20.37 | |
Providence
| Facility | $4.20 | $4.20 | $4.20 | |
Providence
| Professional | $10.81 | $10.81 | $10.81 |