| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $1,445.44 | $2,238.72 | $3,162.28 | |
Moda Health
| Professional | $2,344.23 | $2,344.23 | $2,344.23 | |
Pacific Source
| Facility | $1,548.82 | $2,187.76 | $2,511.89 | |
Providence
| Facility | $1,445.44 | $2,187.76 | $3,162.28 | |
Providence
| Professional | $2,344.23 | $2,344.23 | $2,344.23 |