| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $56.86 | $99.84 | $142.54 | |
Moda Health
| Professional | $106.29 | $106.29 | $106.29 | |
Providence
| Facility | $56.86 | $101.60 | $142.54 | |
Providence
| Professional | $106.29 | $106.29 | $106.29 |