| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $346.74 | $346.74 | $371.54 | |
Moda Health
| Facility | $213.80 | $213.80 | $213.80 | |
Moda Health
| Professional | $60.26 | $346.74 | $371.54 | |
Providence
| Facility | $213.80 | $213.80 | $213.80 | |
Providence
| Professional | $60.26 | $79.43 | $79.43 |