| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,492.03 | $14,227.00 | $14,227.00 | |
Moda Health
| Facility | $2,178.00 | $2,178.00 | $2,178.00 | |
Premera BCBS
| Facility | $4,282.80 | $4,282.80 | $4,282.80 | |
Providence
| Facility | $4,282.80 | $4,282.80 | $4,282.80 | |
United
| Facility | $656.00 | $683.00 | $765.00 |