| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $534.83 | $895.19 | $1,392.39 | |
Moda Health
| Professional | $820.84 | $820.84 | $820.84 | |
Providence
| Facility | $593.39 | $873.92 | $1,330.56 | |
Providence
| Professional | $820.84 | $820.84 | $820.84 |