| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $50.09 | $144.57 | $430.68 | |
Moda Health
| Professional | $201.69 | $201.69 | $250.20 | |
Premera BCBS
| Facility | $499.21 | $499.21 | $499.21 | |
Premera BCBS
| Professional | $128.37 | $320.92 | $320.92 | |
Providence
| Facility | $499.21 | $499.21 | $499.21 | |
Providence
| Professional | $392.23 | $392.23 | $392.23 |