| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $898.48 | $1,129.08 | $1,456.89 | |
Moda Health
| Professional | $1,088.42 | $1,088.42 | $1,088.42 | |
Providence
| Facility | $898.48 | $1,129.08 | $1,456.89 | |
Providence
| Professional | $1,088.42 | $1,088.42 | $1,088.42 |