| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,285.00 | $11,709.00 | $17,611.09 | |
Aetna
| Professional | $688.00 | $688.00 | $688.00 | |
Moda Health
| Facility | $688.00 | $963.20 | $983.84 | |
Providence
| Facility | $688.00 | $963.20 | $983.84 |