| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $32.79 | $65.55 | $76.70 | |
Moda Health
| Professional | $69.55 | $69.55 | $69.55 | |
Providence
| Facility | $32.79 | $66.52 | $76.70 | |
Providence
| Professional | $69.55 | $69.55 | $69.55 |