| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $3,618.99 | $3,618.99 | $3,618.99 | |
Moda Health
| Professional | $825.60 | $825.60 | $1,179.43 | |
Providence
| Facility | $3,467.14 | $3,467.14 | $3,618.99 | |
Providence
| Professional | $825.60 | $825.60 | $1,179.43 | |
United
| Professional | $116.10 | $2,945.55 | $11,236.68 |