| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $5,707.35 | $26,542.00 | $26,542.00 | |
Lucent Health
| Professional | $4,246.00 | $4,246.00 | $4,246.00 | |
Moda Health
| Facility | $767.49 | $989.40 | $1,380.55 | |
Oscar Health
| Professional | $870.20 | $870.20 | $870.20 | |
Providence
| Facility | $767.49 | $997.73 | $1,404.00 |