| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $2,210.84 | $2,954.89 | $3,912.51 | |
Moda Health
| Professional | $2,910.60 | $2,910.60 | $2,910.60 | |
Providence
| Facility | $2,210.84 | $2,954.89 | $3,912.51 | |
Providence
| Professional | $2,910.60 | $2,910.60 | $2,910.60 |