| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $537.03 | $812.83 | $1,202.26 | |
Moda Health
| Professional | $812.83 | $812.83 | $812.83 | |
Providence
| Facility | $537.03 | $776.25 | $1,202.26 | |
Providence
| Professional | $812.83 | $812.83 | $812.83 |