| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,923.34 | $9,577.00 | $14,552.94 | |
Aetna
| Facility | 52 | $1,541.28 | $1,541.28 | $1,541.28 |
Moda Health
| Facility | $1,066.95 | $5,635.49 | $7,889.69 | |
Providence
| Facility | $1,066.95 | $5,635.49 | $7,889.69 |