| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $691.83 | $1,047.13 | $1,548.82 | |
Moda Health
| Professional | $1,096.48 | $1,096.48 | $1,096.48 | |
Providence
| Facility | $691.83 | $1,023.29 | $1,513.56 | |
Providence
| Professional | $1,096.48 | $1,096.48 | $1,096.48 |