| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $687.78 | $918.72 | $1,232.01 | |
Moda Health
| Professional | $1,047.54 | $1,047.54 | $1,047.54 | |
Providence
| Facility | $689.36 | $918.72 | $1,232.01 | |
Providence
| Professional | $1,047.54 | $1,047.54 | $1,047.54 |