| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.78 | $24.78 | $30.98 | |
Moda Health
| Facility | $10.89 | $19.50 | $60.00 | |
Moda Health
| Professional | $1,638.12 | $1,638.12 | $1,638.12 | |
Providence
| Facility | $10.89 | $14.11 | $29.88 | |
Providence
| Professional | $1,638.12 | $1,638.12 | $1,638.12 |