| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $385.76 | $6,684.52 | $47,924.15 | |
Aetna
| Facility | 50 | $5,410.59 | $5,410.59 | $5,410.59 |
Moda Health
| Facility | $158.25 | $289.73 | $369.55 | |
United
| Facility | $1,800.00 | $8,244.00 | $9,193.00 |