| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $7,943.28 | $7,943.28 | $9,332.54 | |
Moda Health
| Facility | $3,801.89 | $7,943.28 | $7,943.28 | |
Moda Health
| Professional | $60.26 | $7,079.46 | $7,943.28 | |
Providence
| Facility | $3,801.89 | $7,943.28 | $7,943.28 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |