| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,371.56 | $7,346.97 | $13,413.92 | |
Moda Health
| Facility | $461.02 | $2,326.23 | $3,256.72 | |
Providence
| Facility | $461.02 | $2,326.23 | $3,256.72 | |
United
| Facility | $6,489.22 | $6,489.22 | $6,489.22 |