| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $117.49 | $147.91 | $186.21 | |
Moda Health
| Professional | $181.97 | $181.97 | $181.97 | |
Providence
| Facility | $102.33 | $165.96 | $213.80 | |
Providence
| Professional | $181.97 | $181.97 | $181.97 |