| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $638.11 | $1,010.76 | $5,378.66 | |
Moda Health
| Professional | $765.33 | $765.33 | $765.33 | |
Providence
| Facility | $638.11 | $1,010.76 | $5,378.66 | |
Providence
| Professional | $765.33 | $765.33 | $765.33 |