| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $229.09 | $416.87 | $831.76 | |
Moda Health
| Professional | $371.54 | $371.54 | $371.54 | |
Providence
| Facility | $229.09 | $416.87 | $831.76 | |
Providence
| Professional | $371.54 | $371.54 | $371.54 |