| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $275.42 | $501.19 | $707.95 | |
Moda Health
| Professional | $537.03 | $537.03 | $537.03 | |
Providence
| Facility | $302.00 | $478.63 | $707.95 | |
Providence
| Professional | $537.03 | $537.03 | $537.03 |