| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.04 | $108.04 | $381.96 | |
Aetna
| Professional | $67.09 | $109.13 | $109.13 | |
Moda Health
| Facility | $156.06 | $156.06 | $156.06 | |
Providence
| Facility | $156.06 | $156.06 | $156.06 | |
United
| Professional | $80.84 | $121.26 | $163.07 |