| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $53.20 | $59.86 | $76.81 | |
Moda Health
| Professional | $56.01 | $56.01 | $56.01 | |
Providence
| Facility | $53.20 | $58.96 | $76.81 | |
Providence
| Professional | $56.01 | $56.01 | $56.01 |