| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $91.27 | $91.27 | $114.09 | |
Moda Health
| Facility | $41.64 | $56.87 | $134.80 | |
Moda Health
| Professional | $6,011.55 | $6,011.55 | $6,011.55 | |
Providence
| Facility | $41.64 | $51.79 | $109.67 | |
Providence
| Professional | $6,011.55 | $6,011.55 | $6,011.55 |