| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11,668.90 | $18,358.91 | $34,743.68 | |
Aetna
| Professional | $1,630.18 | $1,630.18 | $11,668.90 | |
Moda Health
| Facility | $1,630.18 | $1,630.18 | $19,159.50 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |