| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.08 | $28.08 | $35.11 | |
Moda Health
| Facility | $12.31 | $21.91 | $67.40 | |
Moda Health
| Professional | $1,850.55 | $1,850.55 | $1,850.55 | |
Providence
| Facility | $12.31 | $15.60 | $33.76 | |
Providence
| Professional | $1,850.55 | $1,850.55 | $1,850.55 |