| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,061.80 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $3,478.71 | $4,870.18 | $5,603.74 | |
Providence
| Facility | $3,478.71 | $4,870.18 | $5,603.74 |
Epidrm Agrft T/A/L 1st 100 Cm/&/1% Bdy Inft/Chld
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,061.80 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $3,478.71 | $4,870.18 | $5,603.74 | |
Providence
| Facility | $3,478.71 | $4,870.18 | $5,603.74 |