| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $2,406.91 | $2,406.91 | $2,883.76 | |
Lucent Health
| Facility | $1,916.67 | $5,083.49 | $5,083.49 | |
Lucent Health
| Professional | $8,385.44 | $8,385.44 | $8,385.44 | |
Moda Health
| Professional | $59,999.40 | $59,999.40 | $59,999.40 |