| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $54.95 | $56.23 | $3,630.78 | |
Lucent Health
| Professional | $4,265.80 | $4,265.80 | $5,370.32 | |
Moda Health
| Facility | $1,071.52 | $1,412.54 | $1,995.26 | |
Providence
| Facility | $1,047.13 | $1,412.54 | $1,995.26 |