| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $12.59 | $12.59 | |
Moda Health
| Facility | $0.85 | $0.85 | $0.85 | |
Moda Health
| Professional | $1.00 | $12.59 | $79.43 | |
Providence
| Facility | $0.85 | $0.85 | $0.85 | |
Providence
| Professional | $70.79 | $79.43 | $79.43 |