| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $46.11 | $80.34 | $127.73 | |
Moda Health
| Professional | $92.97 | $92.97 | $92.97 | |
Providence
| Facility | $46.11 | $84.70 | $127.73 | |
Providence
| Professional | $92.97 | $92.97 | $92.97 |