| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $146.88 | $372.83 | $587.25 | |
Moda Health
| Professional | $222.58 | $222.58 | $222.58 | |
Providence
| Facility | $146.88 | $372.83 | $552.41 | |
Providence
| Professional | $222.58 | $222.58 | $222.58 |