| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,204.24 | $2,872.38 | $5,582.70 | |
Aetna
| Professional | $507.78 | $507.78 | $507.78 | |
Cigna
| Professional | $489.34 | $489.34 | $489.34 | |
Moda Health
| Facility | $507.78 | $507.78 | $726.13 | |
Providence
| Facility | $507.78 | $507.78 | $726.13 | |
Providence
| Professional | $489.34 | $489.34 | $2,400,000.00 |