| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $433.26 | $770.25 | $770.25 | |
Lucent Health
| Professional | $1,141.00 | $1,141.00 | $1,141.00 | |
Moda Health
| Facility | $222.68 | $255.70 | $345.53 | |
Providence
| Facility | $222.68 | $256.55 | $345.53 | |
Providence
| Professional | $208.39 | $208.39 | $208.39 |