| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,458.02 | $10,625.00 | $17,617.16 | |
Moda Health
| Facility | $1,029.00 | $3,963.14 | $5,667.29 | |
Providence
| Facility | $1,029.00 | $3,963.14 | $5,667.29 | |
United
| Facility | $20,822.43 | $20,822.43 | $20,822.43 |