| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $129.72 | $601.20 | $674.93 | |
Moda Health
| Professional | $633.58 | $633.58 | $633.58 | |
Providence
| Facility | $129.72 | $576.15 | $674.93 | |
Providence
| Professional | $633.58 | $633.58 | $633.58 |