| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $393.84 | $469.94 | $662.73 | |
Moda Health
| Professional | $483.23 | $483.23 | $483.23 | |
Providence
| Facility | $393.84 | $469.94 | $662.73 | |
Providence
| Professional | $483.23 | $483.23 | $483.23 |