| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,774.00 | $14,552.94 | |
Moda Health
| Facility | $632.40 | $3,326.69 | $4,657.37 | |
Providence
| Facility | $632.40 | $3,326.69 | $4,657.37 | |
United
| Facility | $7,058.12 | $7,058.12 | $7,058.12 |