| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $555.54 | $555.54 | $665.60 | |
Lucent Health
| Facility | $442.40 | $1,221.85 | $1,221.85 | |
Lucent Health
| Professional | $1,935.50 | $2,010.38 | $2,010.38 | |
Moda Health
| Professional | $59,999.40 | $59,999.40 | $59,999.40 |