| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $36.17 | $36.17 | $43.34 | |
Lucent Health
| Facility | $70.00 | $124.95 | $137.13 | |
Lucent Health
| Professional | $199.62 | $199.62 | $199.62 | |
Providence
| Professional | $26.95 | $26.95 | $26.95 |