| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $549.54 | $549.54 | $660.69 | |
Lucent Health
| Facility | $1,348.96 | $1,348.96 | $1,348.96 | |
Lucent Health
| Professional | $2,511.89 | $2,511.89 | $2,511.89 | |
Moda Health
| Professional | $60,255.96 | $60,255.96 | $60,255.96 |