| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $14,552.94 | $80,551.75 | |
Moda Health
| Facility | $1,090.36 | $5,026.83 | $7,188.37 | |
Providence
| Facility | $1,090.36 | $5,026.83 | $7,188.37 | |
United
| Facility | $64,123.16 | $64,123.16 | $64,123.16 |