| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $287.25 | $287.25 | $359.06 | |
Lucent Health
| Facility | $1,574.95 | $58,299.50 | $58,299.50 | |
Lucent Health
| Professional | $3,021.48 | $3,021.48 | $3,021.48 | |
Moda Health
| Professional | $6,276.00 | $6,276.00 | $10,818.00 |