| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,949.84 | $9,549.93 | $16,595.87 | |
Aetna
| Professional | $7,079.46 | $9,549.93 | $16,595.87 | |
Moda Health
| Professional | $60.26 | $60.26 | $1,288.25 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |