| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $275.42 | $426.58 | $549.54 | |
Moda Health
| Professional | $467.74 | $467.74 | $467.74 | |
Providence
| Facility | $288.40 | $416.87 | $537.03 | |
Providence
| Professional | $467.74 | $467.74 | $467.74 |