| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,741.00 | $10,480.00 | $13,413.92 | |
Moda Health
| Facility | $559.00 | $2,848.39 | $3,987.75 | |
Providence
| Facility | $559.00 | $2,848.39 | $3,987.75 | |
United
| Facility | $6,489.22 | $6,489.22 | $6,489.22 |