| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,083.82 | $9,774.00 | $14,552.94 | |
Moda Health
| Facility | $1,297.38 | $5,243.84 | $7,498.69 | |
Providence
| Facility | $1,297.38 | $5,243.84 | $7,498.69 | |
United
| Facility | $11,831.32 | $11,831.32 | $11,831.32 |