| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.19 | $25.19 | $31.49 | |
Moda Health
| Facility | $10.98 | $18.14 | $70.00 | |
Moda Health
| Professional | $1,491.39 | $1,491.39 | $1,491.39 | |
Providence
| Facility | $10.98 | $14.22 | $27.20 | |
Providence
| Professional | $1,491.39 | $1,491.39 | $1,491.39 |