| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $3,182.22 | $3,182.22 | $3,812.66 | |
Lucent Health
| Facility | $3,396.06 | $3,647.62 | $4,377.14 | |
Lucent Health
| Professional | $8,804.60 | $8,804.60 | $8,804.60 | |
Moda Health
| Professional | $2,515.60 | $2,515.60 | $2,515.60 | |
Providence
| Professional | $2,767.16 | $2,767.16 | $2,892.94 |