| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.54 | $27.54 | $33.88 | |
Moda Health
| Facility | $11.75 | $15.49 | $51.29 | |
Moda Health
| Professional | $1,778.28 | $1,778.28 | $1,778.28 | |
Providence
| Facility | $11.75 | $21.88 | $51.29 | |
Providence
| Professional | $1,778.28 | $1,778.28 | $1,778.28 |