| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $22.91 | $22.91 | $22.91 | |
BCBS
| Professional | $22.91 | $22.91 | $22.91 | |
Moda Health
| Facility | $1.32 | $1.32 | $1.32 | |
Molina
| Professional | $30.20 | $30.20 | $77.62 | |
Select Health
| Professional | $16.98 | $19.95 | $28.18 |