| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,155.59 | $9,774.00 | $14,552.94 | |
Moda Health
| Facility | $1,329.14 | $1,609.04 | $8,667.20 | |
Providence
| Facility | $1,609.04 | $1,609.04 | $8,667.20 | |
United
| Facility | $4,561.46 | $4,561.46 | $4,561.46 |