| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $1,020.29 | $1,218.59 | $18,239.58 | |
Moda Health
| Professional | $1,160.38 | $1,160.38 | $1,160.38 | |
Providence
| Facility | $988.24 | $1,218.59 | $18,239.58 | |
Providence
| Professional | $1,160.38 | $1,160.38 | $1,160.38 |