| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $195.31 | $346.92 | $467.50 | |
Moda Health
| Professional | $351.17 | $351.17 | $351.17 | |
Providence
| Facility | $196.00 | $336.24 | $467.50 | |
Providence
| Professional | $351.17 | $351.17 | $351.17 |