| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $44.68 | $76.02 | $86.67 | |
Moda Health
| Professional | $75.15 | $75.15 | $75.15 | |
Pacific Source
| Facility | $44.57 | $59.85 | $72.68 | |
Providence
| Facility | $44.68 | $76.02 | $86.67 | |
Providence
| Professional | $75.15 | $75.15 | $75.15 |