| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $43.08 | $74.88 | $106.44 | |
Moda Health
| Professional | $79.69 | $79.69 | $79.69 | |
Providence
| Facility | $43.08 | $76.00 | $106.44 | |
Providence
| Professional | $79.69 | $79.69 | $79.69 |