| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $253.91 | $1,392.76 | $1,949.86 | |
Providence
| Facility | $253.91 | $1,392.76 | $1,949.86 |
Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $253.91 | $1,392.76 | $1,949.86 | |
Providence
| Facility | $253.91 | $1,392.76 | $1,949.86 |