| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.54 | $68.54 | $68.54 | |
Aetna
| Professional | $49.28 | $57.45 | $136.00 | |
Cigna
| Professional | $14.25 | $14.25 | $14.25 | |
Moda Health
| Facility | $57.45 | $57.45 | $57.45 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 |