| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $0.09 | $37.15 | $173.78 | |
Moda Health
| Professional | $32.36 | $32.36 | $32.36 | |
Pacific Source
| Facility | $81.28 | $128.82 | $134.90 | |
Providence
| Facility | $19.05 | $41.69 | $173.78 | |
Providence
| Professional | $32.36 | $32.36 | $32.36 |