| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $30.56 | $30.56 | $38.20 | |
Moda Health
| Facility | $12.03 | $21.91 | $67.40 | |
Moda Health
| Professional | $2,011.88 | $2,011.88 | $2,011.88 | |
Providence
| Facility | $12.03 | $16.96 | $36.71 | |
Providence
| Professional | $2,011.88 | $2,011.88 | $2,011.88 |