| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.15 | $69.18 | $77.62 | |
BCBS
| Professional | $95.50 | $95.50 | $95.50 | |
Cigna
| Professional | $37.15 | $37.15 | $37.15 | |
Moda Health
| Facility | $53.70 | $74.13 | $91.20 | |
Moda Health
| Professional | $61.66 | $87.10 | $91.20 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
Select Health
| Professional | $83.18 | $91.20 | $91.20 | |
United
| Professional | $30.20 | $36.31 | $39.81 |