| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $716.37 | $1,177.97 | $1,765.80 | |
Moda Health
| Professional | $1,102.54 | $1,102.54 | $1,102.54 | |
Providence
| Facility | $794.00 | $1,173.89 | $1,678.05 | |
Providence
| Professional | $1,102.54 | $1,102.54 | $1,102.54 |