| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,021.34 | $1,021.34 | $1,021.34 | |
Aetna
| Professional | $785.65 | $785.65 | $1,974.58 | |
Moda Health
| Facility | $1,123.48 | $1,123.48 | $1,123.48 | |
Providence
| Facility | $1,123.48 | $1,123.48 | $1,123.48 |