| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,473.04 | $6,782.00 | $13,413.92 | |
Aetna
| Professional | $36.00 | $36.00 | $36.00 | |
Moda Health
| Facility | $36.00 | $50.40 | $51.48 | |
Providence
| Facility | $36.00 | $50.40 | $51.48 | |
Providence
| Professional | $2,250,000.00 | $2,250,000.00 | $2,400,000.00 |