| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $548.86 | $548.86 | $548.86 | |
Premera BCBS
| Facility | $3,495.87 | $3,495.87 | $3,495.87 | |
Providence
| Facility | $3,495.87 | $3,495.87 | $3,495.87 | |
Providence
| Professional | $2,250,000.00 | $2,250,000.00 | $2,250,000.00 | |
United
| Professional | $7,200.00 | $7,200.00 | $14,400.00 |