| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $646.41 | $785.01 | $1,008.90 | |
Moda Health
| Professional | $753.46 | $753.46 | $753.46 | |
Providence
| Facility | $646.41 | $785.01 | $1,008.90 | |
Providence
| Professional | $753.46 | $753.46 | $753.46 |