| 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 | $576.38 | $2,247.73 | $3,214.27 | |
Providence
| Facility | $576.38 | $2,247.73 | $3,214.27 | |
United
| Facility | $3,905.54 | $3,905.54 | $3,905.54 |