| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $18.20 | $18.20 | $18.20 | |
Moda Health
| Professional | $18.20 | $18.20 | $54.95 | |
Premera BCBS
| Professional | $16.60 | $41.69 | $41.69 | |
Providence
| Facility | $14.79 | $14.79 | $14.79 | |
United
| Professional | $10.96 | $37.15 | $54.95 |