| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $39.96 | $53.52 | $61.42 | |
Moda Health
| Professional | $51.98 | $51.98 | $51.98 | |
Pacific Source
| Facility | $32.34 | $43.23 | $50.16 | |
Providence
| Facility | $39.96 | $53.52 | $61.42 | |
Providence
| Professional | $51.98 | $51.98 | $51.98 |