| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,598.49 | $13,413.92 | $20,143.00 | |
Moda Health
| Facility | $1,514.30 | $1,827.48 | $9,883.65 | |
Providence
| Facility | $1,827.48 | $1,827.48 | $9,883.65 | |
United
| Facility | $8,045.72 | $8,045.72 | $8,045.72 |