| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $26.43 | $26.43 | $33.04 | |
Moda Health
| Facility | $11.54 | $21.11 | $88.00 | |
Moda Health
| Professional | $1,735.94 | $1,735.94 | $1,735.94 | |
Providence
| Facility | $11.54 | $14.95 | $31.66 | |
Providence
| Professional | $1,735.94 | $1,735.94 | $1,735.94 |