| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $912.01 | $1,071.52 | $1,071.52 | |
Moda Health
| Facility | $1,000.00 | $1,071.52 | $1,737.80 | |
Moda Health
| Professional | $60.26 | $1,000.00 | $1,071.52 | |
Providence
| Facility | $912.01 | $1,071.52 | $1,737.80 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |