| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $818.48 | $1,624.95 | $2,460.78 | |
Moda Health
| Professional | $1,471.29 | $1,471.29 | $1,471.29 | |
Providence
| Facility | $881.55 | $1,562.96 | $2,344.82 | |
Providence
| Professional | $1,471.29 | $1,471.29 | $1,471.29 |