| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $155.94 | $174.86 | $215.66 | |
Moda Health
| Professional | $168.55 | $168.55 | $168.55 | |
Providence
| Facility | $155.94 | $174.86 | $215.66 | |
Providence
| Professional | $168.55 | $168.55 | $168.55 |