| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $134.90 | $257.04 | $537.03 | |
Moda Health
| Professional | $229.09 | $229.09 | $229.09 | |
Providence
| Facility | $134.90 | $269.15 | $537.03 | |
Providence
| Professional | $229.09 | $229.09 | $229.09 |