| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8,836.00 | $10,480.00 | $13,413.92 | |
Aetna
| Professional | $53.91 | $656.25 | $656.25 | |
Moda Health
| Facility | $656.25 | $918.75 | $938.44 | |
Providence
| Facility | $656.25 | $918.75 | $938.44 |