| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $1,551.05 | $3,151.30 | $3,990.53 | |
Lucent Health
| Facility | $55.00 | $2,800.00 | $22,807.05 | |
Lucent Health
| Professional | $4,157.81 | $4,349.77 | $4,349.77 | |
Moda Health
| Facility | $15,268.33 | $15,268.33 | $72,562.71 | |
Oscar Health
| Professional | $7.00 | $1,088.50 | $2,131.40 |