| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $95.40 | $423.67 | $557.21 | |
Moda Health
| Professional | $420.41 | $420.41 | $420.41 | |
Providence
| Facility | $95.40 | $423.67 | $557.21 | |
Providence
| Professional | $420.41 | $420.41 | $420.41 |