| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,511.89 | $6,606.93 | $16,595.87 | |
Aetna
| Professional | $1,698.24 | $1,698.24 | $1,698.24 | |
Moda Health
| Professional | $60.26 | $229.09 | $1,778.28 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |