| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $949.54 | $1,170.81 | $1,518.91 | |
Moda Health
| Professional | $1,149.56 | $1,149.56 | $1,149.56 | |
Providence
| Facility | $949.54 | $1,170.81 | $1,518.91 | |
Providence
| Professional | $1,149.56 | $1,149.56 | $1,149.56 |