| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $349.67 | $468.00 | $639.09 | |
Moda Health
| Professional | $545.59 | $545.59 | $545.59 | |
Providence
| Facility | $353.48 | $468.00 | $639.09 | |
Providence
| Professional | $545.59 | $545.59 | $545.59 |