| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $605.01 | $803.28 | $984.96 | |
Moda Health
| Professional | $826.04 | $826.04 | $826.04 | |
Providence
| Facility | $605.01 | $797.04 | $984.96 | |
Providence
| Professional | $826.04 | $826.04 | $826.04 |