| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $55.00 | $55.00 | $5,184.27 | |
Lucent Health
| Professional | $13,636.00 | $13,636.00 | $13,636.00 | |
Moda Health
| Facility | $1,447.78 | $2,036.46 | $3,230.72 | |
Oscar Health
| Professional | $2,478.10 | $2,478.10 | $2,478.10 | |
Providence
| Facility | $1,447.78 | $2,036.46 | $3,230.72 |