| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,628.00 | $4,500.00 | $7,205.00 | |
Moda Health
| Facility | $111.96 | $180.84 | $360.64 | |
Regence BlueShield
| Facility | $2,644.53 | $3,450.06 | $4,648.81 | |
United
| Facility | $3,450.00 | $6,124.00 | $7,609.00 |