| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,500.00 | $1,500.00 | $1,500.00 | |
Aetna
| Professional | $30.00 | $30.00 | $1,500.00 | |
Moda Health
| Facility | $30.00 | $38.40 | $54.90 | |
Molina
| Professional | $30.00 | $3,500.00 | $3,900.00 |