| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $6,825.52 | $13,413.92 | |
Moda Health
| Facility | $388.59 | $1,915.41 | $2,681.57 | |
Providence
| Facility | $388.59 | $1,915.41 | $2,681.57 | |
United
| Facility | $3,905.54 | $3,905.54 | $3,905.54 |