| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $44.51 | $44.51 | $53.33 | |
Lucent Health
| Facility | $91.08 | $165.99 | $175.00 | |
Lucent Health
| Professional | $233.87 | $233.87 | $233.87 | |
Moda Health
| Facility | $25.86 | $46.84 | $68.11 | |
Providence
| Facility | $25.86 | $46.94 | $68.11 |