| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $645.65 | $7,079.46 | $14,125.38 | |
Moda Health
| Facility | $208.93 | $812.83 | $1,949.84 | |
Providence
| Facility | $208.93 | $812.83 | $1,659.59 | |
United
| Facility | $4,786.30 | $4,786.30 | $4,786.30 |