| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $46.77 | $69.18 | $97.72 | |
Moda Health
| Professional | $87.10 | $87.10 | $87.10 | |
Providence
| Facility | $46.77 | $74.13 | $102.33 | |
Providence
| Professional | $87.10 | $87.10 | $87.10 |