| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $630.96 | $630.96 | $630.96 | |
Lucent Health
| Professional | $1,258.93 | $1,258.93 | $1,258.93 | |
Moda Health
| Facility | $43.65 | $158.49 | $398.11 | |
Oscar Health
| Professional | $53.70 | $66.07 | $83.18 | |
Providence
| Facility | $83.18 | $213.80 | $354.81 |