| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.50 | $28.50 | $35.61 | |
Moda Health
| Facility | $12.41 | $17.66 | $53.92 | |
Moda Health
| Professional | $1,866.61 | $1,866.61 | $1,866.61 | |
Providence
| Facility | $12.41 | $15.73 | $34.06 | |
Providence
| Professional | $1,866.61 | $1,866.61 | $1,866.61 |