| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $600.99 | $998.49 | $1,149.59 | |
Moda Health
| Professional | $861.57 | $861.57 | $861.57 | |
Pacific Source
| Facility | $545.86 | $734.50 | $833.00 | |
Providence
| Facility | $600.99 | $998.49 | $1,149.59 | |
Providence
| Professional | $861.57 | $861.57 | $861.57 |