| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,631.81 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $226.23 | $1,225.72 | $1,716.01 | |
Providence
| Facility | $226.23 | $1,225.72 | $1,716.01 | |
United
| Facility | $3,793.98 | $3,793.98 | $3,793.98 |