| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $348.71 | $627.45 | $627.45 | |
Lucent Health
| Professional | $720.48 | $720.48 | $720.48 | |
Moda Health
| Facility | $93.17 | $145.88 | $281.89 | |
Providence
| Facility | $93.17 | $145.88 | $281.89 | |
Providence
| Professional | $188.31 | $188.31 | $188.31 |