| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,046.95 | $5,563.56 | $5,563.56 | |
Lucent Health
| Professional | $2,763.00 | $3,136.59 | $3,136.59 | |
Moda Health
| Facility | $359.53 | $462.79 | $687.55 | |
Providence
| Facility | $359.53 | $462.79 | $687.55 | |
Providence
| Professional | $432.32 | $432.32 | $432.32 |