| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $2,398.83 | $2,398.83 | $2,884.03 | |
Lucent Health
| Facility | $5,888.44 | $5,888.44 | $5,888.44 | |
Lucent Health
| Professional | $10,715.19 | $10,715.19 | $10,715.19 | |
Moda Health
| Professional | $60,255.96 | $60,255.96 | $60,255.96 |