| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,771.33 | $9,577.00 | $14,552.94 | |
Moda Health
| Facility | $746.05 | $2,887.17 | $4,128.64 | |
Providence
| Facility | $746.05 | $2,887.17 | $4,128.64 | |
United
| Facility | $7,373.90 | $7,373.90 | $7,373.90 |