| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $38.40 | $50.61 | $57.27 | |
Moda Health
| Professional | $49.17 | $49.17 | $49.17 | |
Pacific Source
| Facility | $31.01 | $41.27 | $47.60 | |
Providence
| Facility | $38.40 | $50.61 | $57.27 | |
Providence
| Professional | $49.17 | $49.17 | $49.17 |