| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $40.74 | $40.74 | $50.12 | |
Moda Health
| Facility | $17.78 | $32.36 | $77.62 | |
Moda Health
| Professional | $2,630.27 | $2,630.27 | $2,630.27 | |
Providence
| Facility | $17.78 | $32.36 | $77.62 | |
Providence
| Professional | $2,630.27 | $2,630.27 | $2,630.27 |