| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $55.00 | $55.00 | $5,062.97 | |
Lucent Health
| Professional | $8,345.00 | $8,345.00 | $8,345.00 | |
Moda Health
| Facility | $1,447.18 | $1,884.36 | $4,855.28 | |
Oscar Health
| Professional | $1,837.40 | $1,837.40 | $1,837.40 | |
Providence
| Facility | $1,447.18 | $1,884.36 | $4,855.28 |