| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.02 | $12.02 | $19.05 | |
Moda Health
| Facility | $19.05 | $19.05 | $26.92 | |
Moda Health
| Professional | $10.23 | $12.02 | $60.26 | |
Providence
| Facility | $19.05 | $19.05 | $26.92 | |
Providence
| Professional | $8.91 | $14.79 | $60.26 | |
United
| Professional | $56.23 | $56.23 | $141.25 |