| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $2,344.23 | $2,344.23 | $2,344.23 | |
Lucent Health
| Professional | $2,344.23 | $2,951.21 | $2,951.21 | |
United
| Facility | $467.74 | $467.74 | $467.74 | |
United
| Professional | $338.84 | $407.38 | $676.08 |