| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,230.48 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $947.25 | $3,527.48 | $5,044.30 | |
Providence
| Facility | $947.25 | $3,527.48 | $5,044.30 | |
United
| Facility | $25,984.84 | $25,984.84 | $25,984.84 |