| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.28 | $57.45 | $72.00 | |
Cigna
| Professional | $14.25 | $14.25 | $14.25 | |
Moda Health
| Facility | $49.28 | $57.45 | $88.59 | |
Moda Health
| Professional | $80.00 | $80.00 | $80.00 | |
Providence
| Facility | $49.28 | $57.45 | $88.59 | |
Providence
| Professional | $14.25 | $14.25 | $175.00 |