| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $120.23 | $295.12 | $512.86 | |
Moda Health
| Professional | $223.87 | $223.87 | $223.87 | |
Providence
| Facility | $117.49 | $281.84 | $512.86 | |
Providence
| Professional | $223.87 | $223.87 | $223.87 |