| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $821.42 | $140,989.54 | $140,989.54 | |
Lucent Health
| Professional | $2,224.71 | $2,224.71 | $2,224.71 | |
Moda Health
| Professional | $5,478.00 | $5,478.00 | $15,626.00 |