| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $20.65 | $20.65 | $25.81 | |
Moda Health
| Facility | $9.08 | $15.60 | $48.00 | |
Moda Health
| Professional | $1,365.83 | $1,365.83 | $1,365.83 | |
Providence
| Facility | $9.08 | $9.08 | $24.93 | |
Providence
| Professional | $1,365.83 | $1,365.83 | $1,365.83 |