| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $20.65 | $20.65 | $25.81 | |
Moda Health
| Facility | $9.10 | $16.66 | $67.40 | |
Moda Health
| Professional | $1,369.48 | $1,369.48 | $1,369.48 | |
Providence
| Facility | $9.10 | $11.80 | $24.99 | |
Providence
| Professional | $1,369.48 | $1,369.48 | $1,369.48 |