| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,464.00 | $6,782.00 | $13,413.92 | |
Moda Health
| Facility | $972.55 | $3,817.32 | $5,458.77 | |
Providence
| Facility | $972.55 | $3,817.32 | $5,458.77 | |
United
| Facility | $6,359.06 | $6,359.06 | $6,359.06 |