| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $404.13 | $404.13 | $912.40 | |
Cigna
| Professional | $104.51 | $104.51 | $104.51 | |
Moda Health
| Facility | $404.13 | $404.13 | $868.88 | |
Providence
| Facility | $404.13 | $404.13 | $868.88 | |
Providence
| Professional | $104.51 | $104.51 | $2,400,000.00 |