| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $447.40 | $2,094.32 | $4,313.03 | |
Providence
| Facility | $447.40 | $2,094.32 | $14,001.98 | |
United
| Facility | $6,791.00 | $6,791.00 | $6,791.00 |