| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,285.00 | $10,900.00 | $14,552.94 | |
Aetna
| Professional | $655.61 | $655.61 | $655.61 | |
Moda Health
| Facility | $937.52 | $937.52 | $937.52 | |
Providence
| Facility | $898.19 | $898.19 | $937.52 |