| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $5.25 | $17.32 | $67.40 | |
Moda Health
| Professional | $56.18 | $56.18 | $56.18 | |
Providence
| Facility | $5.25 | $12.00 | $25.97 | |
Providence
| Professional | $56.18 | $56.18 | $56.18 |