| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $15.69 | $15.69 | $19.62 | |
Moda Health
| Facility | $6.77 | $9.63 | $28.00 | |
Moda Health
| Professional | $1,019.08 | $1,019.08 | $1,019.08 | |
Providence
| Facility | $6.77 | $8.58 | $18.57 | |
Providence
| Professional | $1,019.08 | $1,019.08 | $1,019.08 |