| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $559.50 | $685.23 | $893.20 | |
Moda Health
| Professional | $664.04 | $664.04 | $664.04 | |
Providence
| Facility | $559.50 | $685.23 | $893.20 | |
Providence
| Professional | $664.04 | $664.04 | $664.04 |