| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Aetna
| Facility | 52 | $368.98 | $368.98 | $1,726.24 |
Moda Health
| Facility | $310.52 | $1,683.99 | $7,878.29 | |
Providence
| Facility | $310.52 | $1,683.99 | $7,878.29 |