| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $467.74 | $467.74 | $467.74 | |
Moda Health
| Professional | $478.63 | $478.63 | $478.63 | |
Providence
| Facility | $398.11 | $446.68 | $660.69 | |
Providence
| Professional | $478.63 | $478.63 | $478.63 |