| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.60 | $9.60 | $9.60 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Moda Health
| Facility | $14.62 | $14.62 | $15.36 | |
Providence
| Facility | $9.60 | $14.62 | $15.36 | |
United
| Facility | $7.13 | $7.42 | $9.77 |