| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $54.95 | $56.23 | $2,041.74 | |
Lucent Health
| Professional | $1,445.44 | $1,445.44 | $1,445.44 | |
Moda Health
| Facility | $275.42 | $354.81 | $537.03 | |
Providence
| Facility | $269.15 | $354.81 | $549.54 |