| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $54.95 | $56.23 | $5,011.87 | |
Lucent Health
| Professional | $1,737.80 | $1,737.80 | $4,168.69 | |
Moda Health
| Facility | $380.19 | $501.19 | $707.95 | |
Providence
| Facility | $380.19 | $501.19 | $707.95 |