| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $926.37 | $1,743.73 | $2,996.25 |
Opn Subcla Crtd Art Trpos Nck Inc Ulat
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $926.37 | $1,743.73 | $2,996.25 |