| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,285.00 | $10,900.00 | $14,552.94 | |
Aetna
| Professional | $47.86 | $1,456.81 | $1,456.81 | |
Cigna
| Professional | $7.60 | $7.60 | $7.60 | |
Moda Health
| Facility | $47.86 | $67.00 | $68.44 | |
Providence
| Facility | $47.86 | $67.00 | $68.44 | |
Providence
| Professional | $7.60 | $7.60 | $7.60 |