| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.37 | $24.37 | $30.46 | |
Moda Health
| Facility | $10.71 | $17.96 | $55.26 | |
Moda Health
| Professional | $1,610.38 | $1,610.38 | $1,610.38 | |
Providence
| Facility | $10.71 | $13.87 | $29.38 | |
Providence
| Professional | $1,610.38 | $1,610.38 | $1,610.38 |