| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $23.99 | $23.99 | $30.20 | |
Moda Health
| Facility | $48.98 | $48.98 | $48.98 | |
Moda Health
| Professional | $20.42 | $20.42 | $20.42 | |
Providence
| Facility | $48.98 | $48.98 | $48.98 | |
Providence
| Professional | $70.79 | $79.43 | $79.43 |