| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $28.84 | $45.71 | $58.88 | |
Moda Health
| Professional | $56.23 | $56.23 | $56.23 | |
Providence
| Facility | $38.02 | $54.95 | $75.86 | |
Providence
| Professional | $56.23 | $56.23 | $56.23 |