| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $954.48 | $1,184.60 | $1,221.63 | |
Lucent Health
| Facility | $55.00 | $55.00 | $9,546.12 | |
Moda Health
| Facility | $777.40 | $985.48 | $1,792.56 | |
Providence
| Facility | $748.01 | $1,058.53 | $1,985.64 |