| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $454.72 | $543.75 | $11,318.13 | |
Moda Health
| Professional | $526.26 | $526.26 | $526.26 | |
Providence
| Facility | $437.51 | $543.75 | $11,318.13 | |
Providence
| Professional | $526.26 | $526.26 | $526.26 |