| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $467.74 | $630.96 | $776.25 | |
Moda Health
| Professional | $660.69 | $660.69 | $660.69 | |
Providence
| Facility | $467.74 | $645.65 | $891.25 | |
Providence
| Professional | $660.69 | $660.69 | $660.69 |