| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $851.60 | $3,565.85 | $3,565.85 | |
Lucent Health
| Professional | $1,655.89 | $1,655.89 | $1,655.89 | |
Moda Health
| Facility | $284.91 | $380.67 | $556.48 | |
Providence
| Facility | $284.91 | $385.64 | $533.38 | |
Providence
| Professional | $377.37 | $377.37 | $377.37 |