| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,288.98 | $9,813.00 | $17,617.16 | |
Aetna
| Facility | 50 | $0.66 | $0.66 | $2,236.00 |
Moda Health
| Facility | $1,390.55 | $5,549.25 | $7,935.43 | |
Providence
| Facility | $1,390.55 | $5,549.25 | $7,935.43 |