| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $346.74 | $346.74 | $346.74 | |
Lucent Health
| Professional | $229.09 | $229.09 | $257.04 | |
Moda Health
| Facility | $32.36 | $32.36 | $72.44 | |
Providence
| Facility | $39.81 | $61.66 | $107.15 |