| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,495.86 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $154.85 | $590.53 | $1,012.88 | |
Providence
| Facility | $154.85 | $590.53 | $3,936.17 | |
United
| Facility | $200.00 | $200.00 | $200.00 |