| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $91.27 | $91.27 | $114.09 | |
Lucent Health
| Facility | $122.00 | $268.30 | $268.30 | |
Moda Health
| Facility | $41.64 | $51.79 | $108.62 | |
Providence
| Facility | $41.64 | $51.79 | $108.62 | |
Providence
| Professional | $87.44 | $87.44 | $87.44 |