| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,774.00 | $14,552.94 | |
Moda Health
| Facility | $697.42 | $3,575.24 | $5,005.34 | |
Providence
| Facility | $697.42 | $3,575.24 | $5,005.34 | |
United
| Facility | $14,287.46 | $14,287.46 | $14,287.46 |