| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $97.71 | $97.71 | $97.71 | |
Moda Health
| Facility | $12.06 | $12.06 | $12.06 | |
Providence
| Facility | $12.06 | $12.06 | $97.71 | |
Providence
| Professional | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 |