| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $35.48 | $35.48 | $42.66 | |
Lucent Health
| Facility | $173.78 | $181.97 | $181.97 | |
Lucent Health
| Professional | $190.55 | $190.55 | $190.55 | |
Moda Health
| Facility | $28.84 | $42.66 | $63.10 | |
Providence
| Facility | $28.84 | $42.66 | $64.57 |