| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $55.00 | $55.00 | $7,191.61 | |
Lucent Health
| Facility | AS | $397.63 | $719.16 | $719.16 |
Providence
| Facility | $4,468.13 | $4,468.13 | $4,468.13 | |
Providence
| Facility | 80 | $664.76 | $664.76 | $664.76 |
Providence
| Facility | AS | $565.04 | $565.04 | $565.04 |