| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.00 | $50.00 | $242.40 | |
Christus
| Facility | $20.17 | $83.64 | $83.64 | |
Lucent Health
| Facility | $104.00 | $104.00 | $180.00 | |
Moda Health
| Facility | $2,846.10 | $5,350.00 | $6,105.00 | |
Providence
| Facility | $271.95 | $4,750.00 | $6,105.00 |