| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $55.34 | $55.34 | $69.18 | |
Moda Health
| Facility | $21.71 | $35.04 | $107.84 | |
Moda Health
| Professional | $3,628.83 | $3,628.83 | $3,628.83 | |
Providence
| Facility | $21.71 | $30.59 | $66.20 | |
Providence
| Professional | $3,628.83 | $3,628.83 | $3,628.83 |