| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.91 | $28.91 | $36.14 | |
Moda Health
| Facility | $12.72 | $22.75 | $70.00 | |
Moda Health
| Professional | $1,912.60 | $1,912.60 | $1,912.60 | |
Providence
| Facility | $12.72 | $16.47 | $34.88 | |
Providence
| Professional | $1,912.60 | $1,912.60 | $1,912.60 |