| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,243.00 | $9,813.00 | $14,552.94 | |
Aetna
| Professional | $1,085.10 | $1,085.11 | $1,193.63 | |
Moda Health
| Facility | $1,085.11 | $1,085.11 | $1,551.72 | |
Providence
| Facility | $1,085.11 | $1,085.11 | $1,551.72 |