| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,332.54 | $14,125.38 | $19,054.61 | |
Aetna
| Professional | $10,715.19 | $14,125.38 | $17,782.79 | |
Moda Health
| Facility | $19,054.61 | $19,054.61 | $19,054.61 | |
Moda Health
| Professional | $60.26 | $60.26 | $16,218.10 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |