| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $35.25 | $35.25 | $42.23 | |
Lucent Health
| Facility | $90.00 | $175.00 | $180.00 | |
Lucent Health
| Professional | $192.26 | $192.26 | $192.26 | |
Moda Health
| Facility | $27.54 | $40.52 | $56.16 | |
Providence
| Facility | $27.54 | $40.74 | $56.16 |