| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.37 | $24.37 | $30.46 | |
Moda Health
| Facility | $10.65 | $19.48 | $67.40 | |
Moda Health
| Professional | $1,603.08 | $1,603.08 | $1,603.08 | |
Providence
| Facility | $10.65 | $13.81 | $29.24 | |
Providence
| Professional | $1,603.08 | $1,603.08 | $1,603.08 |