| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $208.93 | $208.93 | $245.47 | |
Lucent Health
| Facility | $436.52 | $436.52 | $436.52 | |
Lucent Health
| Professional | $794.33 | $794.33 | $794.33 | |
Moda Health
| Professional | $177.83 | $177.83 | $177.83 | |
United
| Professional | $74.13 | $74.13 | $104.71 |