| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.67 | $27.67 | $34.59 | |
Moda Health
| Facility | $12.12 | $22.17 | $72.00 | |
Moda Health
| Professional | $1,822.81 | $1,822.81 | $1,822.81 | |
Providence
| Facility | $12.12 | $15.70 | $33.25 | |
Providence
| Professional | $1,822.81 | $1,822.81 | $1,822.81 |