| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $851.14 | $1,513.56 | $1,513.56 | |
Lucent Health
| Professional | $5,754.40 | $5,754.40 | $5,754.40 | |
Moda Health
| Facility | $131.83 | $194.98 | $1,513.56 | |
Providence
| Facility | $128.82 | $190.55 | $1,513.56 |