| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $10,715.19 | $10,715.19 | $10,715.19 | |
Lucent Health
| Professional | $1,318.26 | $1,380.38 | $1,380.38 | |
Providence
| Professional | $288.40 | $288.40 | $288.40 | |
United
| Facility | $2,754.23 | $2,754.23 | $2,754.23 | |
United
| Professional | $93.33 | $125.89 | $194.98 |