| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $93.68 | $93.68 | $112.25 | |
Lucent Health
| Facility | $112.29 | $112.29 | $280.72 | |
Lucent Health
| Professional | $245.63 | $245.63 | $280.72 | |
Moda Health
| Facility | $150.00 | $150.00 | $150.00 | |
Moda Health
| Professional | $44.74 | $44.74 | $44.74 | |
Providence
| Professional | $73.69 | $74.04 | $98.25 |