| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $95.40 | $380.83 | $498.90 | |
Moda Health
| Professional | $377.57 | $377.57 | $377.57 | |
Providence
| Facility | $95.40 | $380.83 | $498.90 | |
Providence
| Professional | $377.57 | $377.57 | $377.57 |