| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $426.58 | $537.03 | $707.95 | |
Moda Health
| Professional | $707.95 | $707.95 | $707.95 | |
Providence
| Facility | $407.38 | $616.60 | $812.83 | |
Providence
| Professional | $707.95 | $707.95 | $707.95 |