| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.38 | $50.38 | $50.38 | |
Moda Health
| Facility | $50.38 | $50.38 | $51.58 | |
Providence
| Facility | $50.38 | $50.38 | $51.58 | |
Providence
| Professional | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 |