| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $36.31 | $60.26 | $81.28 | |
Moda Health
| Professional | $75.86 | $75.86 | $75.86 | |
Pacific Source
| Facility | $44.67 | $61.66 | $69.18 | |
Providence
| Facility | $36.31 | $60.26 | $83.18 | |
Providence
| Professional | $75.86 | $75.86 | $75.86 |