| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.37 | $89.38 | $170.48 | |
BCBS
| Facility | $5,456.92 | $5,821.21 | $8,577.84 | |
Lucent Health
| Facility | $100.00 | $100.00 | $1,245.88 | |
Moda Health
| Facility | $34.85 | $34.85 | $569.85 | |
Wellpoint
| Professional | $750.00 | $750.00 | $750.00 |