| 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 | $192.44 | $1,054.22 | $1,475.91 | |
Providence
| Facility | $192.44 | $1,054.22 | $1,475.91 | |
United
| Facility | $3,793.98 | $3,793.98 | $3,793.98 |