| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $54.95 | $56.23 | $5,754.40 | |
Lucent Health
| Professional | $15,488.17 | $15,488.17 | $15,488.17 | |
Moda Health
| Facility | $1,659.59 | $2,238.72 | $3,548.13 | |
Providence
| Facility | $1,659.59 | $2,238.72 | $3,548.13 |