| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $474.32 | $831.60 | $1,524.13 | |
Lucent Health
| Professional | $5,807.00 | $5,807.00 | $5,807.00 | |
Moda Health
| Facility | $128.31 | $178.21 | $1,541.38 | |
Oscar Health
| Professional | $165.70 | $165.70 | $165.70 | |
Providence
| Facility | $128.31 | $178.21 | $1,541.38 |