| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $35.48 | $50.12 | $70.79 | |
Moda Health
| Professional | $64.57 | $64.57 | $64.57 | |
Pacific Source
| Facility | $38.02 | $52.48 | $60.26 | |
Providence
| Facility | $35.48 | $54.95 | $74.13 | |
Providence
| Professional | $64.57 | $64.57 | $64.57 |