| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,458.64 | $10,202.71 | $14,552.94 | |
Aetna
| Facility | 52 | $2,229.32 | $2,229.32 | $2,229.32 |
Moda Health
| Facility | $1,525.89 | $8,151.28 | $11,411.79 | |
Providence
| Facility | $1,525.89 | $8,151.28 | $11,411.79 |