| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $316.23 | $371.54 | $602.56 | |
Moda Health
| Facility | $316.23 | $416.87 | $660.69 | |
Moda Health
| Professional | $60.26 | $316.23 | $602.56 | |
Providence
| Facility | $316.23 | $398.11 | $602.56 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |