| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $252.11 | $402.44 | $661.57 | |
Moda Health
| Professional | $366.34 | $366.34 | $366.34 | |
Providence
| Facility | $252.11 | $392.35 | $661.57 | |
Providence
| Professional | $366.34 | $366.34 | $366.34 |