| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $93.82 | $217.63 | $317.56 | |
Moda Health
| Professional | $151.44 | $151.44 | $151.44 | |
Providence
| Facility | $93.82 | $217.63 | $317.56 | |
Providence
| Professional | $151.44 | $151.44 | $151.44 |