| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,099.00 | $10,480.00 | $18,105.75 | |
Moda Health
| Facility | $927.17 | $4,778.22 | $6,689.52 | |
Providence
| Facility | $927.17 | $4,778.22 | $6,689.52 | |
United
| Facility | $14,287.46 | $14,287.46 | $14,287.46 |