| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $81.28 | $316.23 | $436.52 | |
Moda Health
| Professional | $380.19 | $380.19 | $380.19 | |
Providence
| Facility | $81.28 | $316.23 | $389.05 | |
Providence
| Professional | $380.19 | $380.19 | $380.19 |