| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,349.51 | $5,563.56 | $5,563.56 | |
Lucent Health
| Professional | $4,522.00 | $4,522.00 | $4,522.00 | |
Moda Health
| Facility | $602.89 | $711.80 | $965.25 | |
Providence
| Facility | $602.89 | $711.80 | $965.25 | |
Providence
| Professional | $602.04 | $602.04 | $602.04 |