| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,447.20 | $10,900.00 | $17,869.00 | |
Moda Health
| Facility | $1,044.93 | $6,271.77 | $8,780.48 | |
Providence
| Facility | $1,044.93 | $6,271.77 | $8,780.48 | |
United
| Facility | $20,822.43 | $20,822.43 | $20,822.43 |