| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $363.08 | $363.08 | $363.08 | |
Lucent Health
| Professional | $363.08 | $363.08 | $363.08 | |
United
| Facility | $125.89 | $125.89 | $125.89 | |
United
| Professional | $50.12 | $67.61 | $107.15 |