| 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 | $370.74 | $1,931.13 | $2,703.58 | |
Providence
| Facility | $370.74 | $1,931.13 | $2,703.58 | |
United
| Facility | $3,905.54 | $3,905.54 | $3,905.54 |