| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $357.37 | $618.84 | $749.25 | |
Moda Health
| Professional | $537.00 | $537.00 | $537.00 | |
Providence
| Facility | $324.66 | $546.00 | $872.84 | |
Providence
| Professional | $537.00 | $537.00 | $537.00 |