| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $318.75 | $318.75 | $318.75 | |
Moda Health
| Facility | $266.10 | $266.10 | $455.81 | |
Moda Health
| Professional | $1,511.00 | $1,511.00 | $1,511.00 | |
Providence
| Facility | $318.75 | $436.69 | $455.81 | |
Providence
| Professional | $1,800,000.00 | $2,400,000.00 | $2,400,000.00 |