| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $30.90 | $43.65 | $57.54 | |
Moda Health
| Professional | $48.98 | $48.98 | $48.98 | |
Pacific Source
| Facility | $30.90 | $41.69 | $47.86 | |
Providence
| Facility | $30.90 | $44.67 | $57.54 | |
Providence
| Professional | $48.98 | $48.98 | $48.98 |