| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $371.32 | $421.31 | $509.69 | |
Moda Health
| Facility | $371.32 | $438.65 | $642.94 | |
Moda Health
| Professional | $4,495.52 | $4,495.52 | $4,903.18 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |