| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.61 | $25.61 | $32.01 | |
Moda Health
| Facility | $11.20 | $17.52 | $53.92 | |
Moda Health
| Professional | $1,684.11 | $1,684.11 | $1,684.11 | |
Providence
| Facility | $11.20 | $14.51 | $30.73 | |
Providence
| Professional | $1,684.11 | $1,684.11 | $1,684.11 |