| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $184.14 | $202.37 | $227.70 | |
Moda Health
| Professional | $184.73 | $184.73 | $184.73 | |
Providence
| Facility | $184.14 | $202.37 | $227.70 | |
Providence
| Professional | $184.73 | $184.73 | $184.73 |