| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $611.52 | $752.36 | $3,895.01 | |
Providence
| Facility | $752.36 | $752.36 | $3,895.01 | |
United
| Facility | $4,561.46 | $4,561.46 | $4,561.46 |