| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $17.92 | $21.47 | $26.48 | |
Lucent Health
| Facility | $90.00 | $90.00 | $99.16 | |
Lucent Health
| Professional | $106.16 | $125.69 | $125.69 | |
Moda Health
| Facility | $21.37 | $27.98 | $35.96 | |
Providence
| Facility | $21.37 | $27.98 | $35.96 |