| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $3,627.32 | $3,627.32 | $3,627.32 | |
Moda Health
| Professional | $824.93 | $824.93 | $1,178.48 | |
Providence
| Facility | $3,475.13 | $3,475.13 | $3,627.32 | |
Providence
| Professional | $824.93 | $824.93 | $1,178.48 | |
United
| Professional | $1,348.66 | $2,945.55 | $11,236.68 |