| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $1,122.02 | $1,122.02 | $1,122.02 | |
Moda Health
| Professional | $977.24 | $977.24 | $977.24 | |
Providence
| Facility | $676.08 | $1,047.13 | $1,174.90 | |
Providence
| Professional | $977.24 | $977.24 | $977.24 |