| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.26 | $27.26 | $34.07 | |
Moda Health
| Facility | $11.83 | $21.65 | $74.14 | |
Moda Health
| Professional | $1,779.74 | $1,779.74 | $1,779.74 | |
Providence
| Facility | $11.83 | $15.33 | $32.47 | |
Providence
| Professional | $1,779.74 | $1,779.74 | $1,779.74 |