| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.00 | $50.00 | $121.20 | |
Christus
| Facility | $20.17 | $40.00 | $80.00 | |
Lucent Health
| Facility | $90.00 | $104.00 | $104.00 | |
Moda Health
| Facility | $105.80 | $3,000.00 | $6,105.00 | |
Providence
| Facility | $81.40 | $2,500.00 | $6,105.00 |