| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $38.01 | $59.86 | $78.68 | |
Moda Health
| Professional | $59.88 | $59.88 | $59.88 | |
Providence
| Facility | $38.01 | $59.86 | $78.68 | |
Providence
| Professional | $59.88 | $59.88 | $59.88 |