| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $7,920.26 | $20,400.00 | |
Aetna
| Professional | $20,400.00 | $20,400.00 | $20,400.00 | |
Moda Health
| Professional | $13,910.16 | $17,150.38 | $18,772.80 | |
United
| Facility | $2,364.00 | $7,664.00 | $36,803.00 |