| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.69 | $111.73 | $122.92 | |
Cigna
| Professional | $60.08 | $60.08 | $60.08 | |
Moda Health
| Facility | $83.17 | $114.62 | $140.37 | |
Moda Health
| Professional | $107.44 | $133.35 | $147.38 | |
Molina
| Professional | $4.25 | $25.00 | $273.72 | |
United
| Professional | $57.74 | $59.42 | $62.45 |