| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,316.91 | $2,895.18 | $2,895.18 | |
Lucent Health
| Professional | $3,816.68 | $3,816.68 | $3,816.68 | |
Moda Health
| Facility | $870.63 | $1,128.89 | $1,482.63 | |
Providence
| Facility | $870.63 | $1,128.89 | $1,521.05 |