| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $776.25 | $3,090.30 | $5,248.07 | |
Moda Health
| Professional | $1,047.13 | $1,047.13 | $1,047.13 | |
Providence
| Facility | $891.25 | $3,311.31 | $5,248.07 | |
Providence
| Professional | $1,047.13 | $1,047.13 | $1,047.13 |