| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $1,414.37 | $2,873.60 | $3,638.88 | |
Lucent Health
| Facility | $11,500.00 | $13,851.75 | $26,542.00 | |
Lucent Health
| Professional | $5,691.35 | $5,691.35 | $5,691.35 | |
Moda Health
| Facility | $3,199.00 | $3,199.00 | $3,199.00 | |
Oscar Health
| Professional | $6.00 | $974.70 | $1,942.00 |