| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,328.00 | $8,303.41 | $13,413.92 | |
Aetna
| Professional | $27.58 | $27.58 | $27.58 | |
Moda Health
| Facility | $27.58 | $38.61 | $39.44 | |
Providence
| Facility | $27.58 | $38.61 | $39.44 | |
Providence
| Professional | $2,250,000.00 | $2,250,000.00 | $2,400,000.00 |