| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,877.57 | $12,525.26 | $25,817.84 | |
Aetna
| Facility | AS | $602.53 | $602.53 | $602.53 |
Moda Health
| Facility | $1,054.54 | $1,577.79 | $2,070.32 | |
Regence BlueShield
| Facility | $11,710.47 | $23,146.31 | $31,188.68 | |
United
| Facility | $11,800.00 | $26,422.00 | $29,092.00 |