| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $58.81 | $58.81 | $58.81 | |
Moda Health
| Professional | $66.01 | $66.01 | $66.01 | |
Providence
| Facility | $58.81 | $58.81 | $58.81 | |
Providence
| Professional | $66.01 | $66.01 | $66.01 |