| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $87.73 | $158.25 | $158.25 | |
Lucent Health
| Professional | $228.00 | $318.20 | $318.20 | |
Moda Health
| Facility | $41.21 | $55.61 | $77.58 | |
Providence
| Facility | $41.21 | $55.61 | $77.58 |