| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,900.76 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $938.34 | $4,792.01 | $6,708.81 | |
Providence
| Facility | $938.34 | $4,792.01 | $6,708.81 | |
United
| Facility | $12,808.14 | $12,808.14 | $12,808.14 |