| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.18 | $28.18 | $35.48 | |
Moda Health
| Facility | $12.30 | $21.88 | $54.95 | |
Moda Health
| Professional | $1,862.09 | $1,862.09 | $1,862.09 | |
Providence
| Facility | $12.30 | $21.88 | $54.95 | |
Providence
| Professional | $1,862.09 | $1,862.09 | $1,862.09 |