| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $159.87 | $194.16 | $234.97 | |
Moda Health
| Facility | $132.34 | $194.16 | $267.19 | |
Moda Health
| Professional | $1,375.47 | $1,375.47 | $1,500.21 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |