| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $166.50 | $1,556.69 | $1,821.49 | |
Lucent Health
| Professional | $5,272.00 | $5,272.00 | $5,272.00 | |
Moda Health
| Facility | $78.39 | $115.84 | $987.64 | |
Oscar Health
| Professional | $126.70 | $126.70 | $126.70 | |
Providence
| Facility | $78.39 | $115.84 | $987.64 |