| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $452.09 | $1,484.70 | $2,106.00 | |
Aetna
| Professional | $314.18 | $314.18 | $314.18 | |
Cigna
| Professional | $52.02 | $52.02 | $52.02 | |
Moda Health
| Facility | $314.18 | $314.18 | $449.28 | |
Providence
| Facility | $314.18 | $314.18 | $449.28 | |
Providence
| Professional | $52.02 | $52.02 | $2,250,000.00 |