| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $65.67 | $65.67 | $82.08 | |
Moda Health
| Facility | $28.70 | $40.83 | $108.51 | |
Moda Health
| Professional | $4,316.49 | $4,316.49 | $4,316.49 | |
Providence
| Facility | $28.70 | $37.18 | $78.75 | |
Providence
| Professional | $4,316.49 | $4,316.49 | $4,316.49 |