| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,519.00 | $19,792.48 | $23,933.30 | |
Aetna
| Professional | $688.00 | $688.00 | $23,933.30 | |
Moda Health
| Facility | $688.00 | $880.64 | $1,259.04 | |
Regence BlueShield
| Facility | $34,874.31 | $34,874.31 | $38,452.31 | |
United
| Facility | $3,700.00 | $62,445.00 | $76,459.00 |