| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,054.80 | $1,946.58 | $1,946.58 | |
Lucent Health
| Professional | $2,567.06 | $2,567.06 | $2,567.06 | |
Moda Health
| Facility | $575.85 | $708.28 | $929.70 | |
Providence
| Facility | $575.85 | $708.28 | $987.36 |