| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $171.91 | $219.78 | $273.98 | |
Moda Health
| Professional | $218.92 | $218.92 | $218.92 | |
Providence
| Facility | $171.91 | $224.00 | $273.98 | |
Providence
| Professional | $218.92 | $218.92 | $218.92 |