| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $52.79 | $52.79 | $56.96 | |
Pacific Source
| Facility | $7.98 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $6.24 | $6.24 | $9.98 | |
Providence
| Professional | $6.24 | $6.24 | $6.24 |