| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $111.38 | $140.07 | $156.80 | |
Moda Health
| Professional | $114.39 | $114.39 | $114.39 | |
Providence
| Facility | $111.38 | $140.07 | $156.80 | |
Providence
| Professional | $114.39 | $114.39 | $114.39 |