| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $10,000.00 | $33,884.42 | $33,884.42 | |
Lucent Health
| Professional | $6,025.60 | $6,025.60 | $6,025.60 | |
Moda Health
| Facility | $1,258.93 | $1,698.24 | $2,454.71 | |
Oscar Health
| Professional | $1,584.89 | $1,584.89 | $1,584.89 | |
Providence
| Facility | $1,258.93 | $1,698.24 | $2,454.71 |