| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8,570.00 | $14,552.94 | $37,740.00 | |
Moda Health
| Facility | $1,536.68 | $7,778.24 | $10,889.54 | |
Providence
| Facility | $1,536.68 | $7,778.24 | $10,889.54 | |
United
| Facility | $36,780.10 | $36,780.10 | $36,780.10 |