| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $870.30 | $1,683.81 | $1,683.81 | |
Lucent Health
| Professional | $5,247.00 | $5,247.00 | $5,247.00 | |
Moda Health
| Facility | $561.76 | $766.50 | $1,003.89 | |
Providence
| Facility | $561.76 | $766.50 | $1,033.88 | |
Providence
| Professional | $526.28 | $526.28 | $526.28 |