| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $851.14 | $1,737.80 | $3,467.37 | |
Christus
| Facility | $85.11 | $1,621.81 | $5,011.87 | |
Lucent Health
| Facility | $2,570.40 | $2,570.40 | $2,570.40 | |
Moda Health
| Facility | $851.14 | $1,737.80 | $2,454.71 |