| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $484.66 | $605.83 | $1,030.32 | |
Lucent Health
| Facility | $662.76 | $1,062.18 | $1,062.18 | |
Lucent Health
| Professional | $1,495.03 | $1,611.85 | $1,611.85 | |
Moda Health
| Facility | $188.33 | $384.70 | $519.26 | |
Providence
| Facility | $188.33 | $384.70 | $519.26 |