| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $2.14 | $138.04 | $549.54 | |
Moda Health
| Professional | $524.81 | $524.81 | $524.81 | |
Providence
| Facility | $346.74 | $512.86 | $9,772.37 | |
Providence
| Professional | $524.81 | $524.81 | $524.81 |