| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,285.00 | $10,900.00 | $14,552.94 | |
Aetna
| Professional | $287.56 | $287.56 | $287.56 | |
Moda Health
| Facility | $411.21 | $411.21 | $411.21 | |
Providence
| Facility | $393.96 | $393.96 | $411.21 |