| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $4,786.30 | $4,786.30 | $4,786.30 | |
Lucent Health
| Professional | $5,754.40 | $7,079.46 | $7,079.46 | |
Moda Health
| Facility | $263.03 | $389.05 | $2,884.03 | |
Providence
| Facility | $263.03 | $389.05 | $2,951.21 |