| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.84 | $28.84 | $36.31 | |
Moda Health
| Facility | $12.59 | $16.60 | $54.95 | |
Moda Health
| Professional | $1,230.27 | $1,230.27 | $1,230.27 | |
Providence
| Facility | $12.59 | $16.60 | $54.95 | |
Providence
| Professional | $1,230.27 | $1,230.27 | $1,230.27 |