| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $3,060.32 | $26,542.00 | $26,542.00 | |
Lucent Health
| Professional | $8,041.00 | $8,942.37 | $8,942.37 | |
Moda Health
| Facility | $1,416.34 | $1,735.05 | $2,707.58 | |
Providence
| Facility | $1,417.04 | $1,736.55 | $2,736.10 |