| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $66.07 | $141.25 | $239.88 | |
Moda Health
| Professional | $104.71 | $104.71 | $104.71 | |
Providence
| Facility | $63.10 | $141.25 | $245.47 | |
Providence
| Professional | $104.71 | $104.71 | $104.71 |