| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $19.50 | $19.50 | $23.99 | |
Moda Health
| Facility | $8.51 | $15.49 | $37.15 | |
Moda Health
| Professional | $1,288.25 | $1,288.25 | $1,288.25 | |
Providence
| Facility | $8.51 | $15.49 | $37.15 | |
Providence
| Professional | $1,288.25 | $1,288.25 | $1,288.25 |