| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.89 | $21.89 | $27.36 | |
Moda Health
| Facility | $9.52 | $17.41 | $67.40 | |
Moda Health
| Professional | $1,431.53 | $1,431.53 | $1,431.53 | |
Providence
| Facility | $9.52 | $12.33 | $26.11 | |
Providence
| Professional | $1,431.53 | $1,431.53 | $1,431.53 |