| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $425.00 | $425.00 | $425.00 | |
Moda Health
| Facility | $299.00 | $299.00 | $607.75 | |
Moda Health
| Professional | $1,469.00 | $1,469.00 | $1,469.00 | |
Providence
| Facility | $425.00 | $582.25 | $607.75 | |
Providence
| Professional | $1,800,000.00 | $2,400,000.00 | $2,400,000.00 |