| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,741.00 | $10,480.00 | $13,413.92 | |
Moda Health
| Facility | $956.22 | $1,166.58 | $6,152.72 | |
Providence
| Facility | $1,166.58 | $1,166.58 | $6,152.72 | |
United
| Facility | $4,561.46 | $4,561.46 | $4,561.46 |