| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $55.00 | $55.00 | $2,242.62 | |
Lucent Health
| Professional | $7,159.00 | $7,159.00 | $7,159.00 | |
Moda Health
| Facility | $633.14 | $825.34 | $1,638.81 | |
Oscar Health
| Professional | $913.60 | $913.60 | $913.60 | |
Providence
| Facility | $633.14 | $825.34 | $1,638.81 |