| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $81.28 | $346.74 | $489.78 | |
Moda Health
| Professional | $416.87 | $416.87 | $416.87 | |
Providence
| Facility | $81.28 | $346.74 | $436.52 | |
Providence
| Professional | $416.87 | $416.87 | $416.87 |