| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $23.99 | $23.99 | $23.99 | |
Moda Health
| Facility | $15.14 | $15.14 | $15.85 | |
Moda Health
| Professional | $19.50 | $19.50 | $19.50 | |
Providence
| Facility | $15.14 | $15.14 | $15.85 | |
Providence
| Professional | $19.50 | $19.50 | $19.50 | |
United
| Professional | $14.45 | $14.45 | $15.14 |