| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,587.92 | $11,154.00 | $16,713.96 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Cigna
| Professional | $24.00 | $24.00 | $24.00 | |
Moda Health
| Facility | $40.00 | $56.00 | $57.20 | |
Providence
| Facility | $40.00 | $56.00 | $57.20 | |
Providence
| Professional | $24.00 | $24.00 | $24.00 |