| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $88.88 | $181.77 | $244.62 | |
Moda Health
| Professional | $103.62 | $103.62 | $103.62 | |
Providence
| Facility | $88.88 | $181.77 | $244.62 | |
Providence
| Professional | $103.62 | $103.62 | $103.62 |