| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $38.02 | $60.26 | $87.10 | |
Moda Health
| Professional | $79.43 | $79.43 | $79.43 | |
Providence
| Facility | $38.02 | $60.26 | $93.33 | |
Providence
| Professional | $79.43 | $79.43 | $79.43 |