| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $190.55 | $194.98 | $194.98 | |
Lucent Health
| Professional | $229.09 | $229.09 | $416.87 | |
Moda Health
| Facility | $36.31 | $36.31 | $114.82 | |
Providence
| Facility | $50.12 | $70.79 | $123.03 |