| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $6,597.99 | $6,597.99 | $7,905.14 | |
Moda Health
| Facility | $2,611.67 | $3,816.92 | $4,802.93 | |
Moda Health
| Professional | $3,538.65 | $3,538.65 | $3,538.65 | |
Providence
| Facility | $2,611.67 | $3,816.92 | $4,802.93 | |
Providence
| Professional | $3,538.65 | $3,538.65 | $3,538.65 |