| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $155.25 | $185.21 | $236.03 | |
Moda Health
| Professional | $181.89 | $181.89 | $181.89 | |
Providence
| Facility | $155.25 | $185.21 | $236.03 | |
Providence
| Professional | $181.89 | $181.89 | $181.89 |