| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $391.94 | $391.94 | $469.59 | |
Lucent Health
| Facility | $222.62 | $600.00 | $600.00 | |
Lucent Health
| Professional | $500.00 | $500.00 | $500.00 | |
Moda Health
| Facility | $34.32 | $117.98 | $2,753.21 | |
Moda Health
| Professional | $76.16 | $94.91 | $216.00 | |
Oscar Health
| Professional | $73.80 | $73.80 | $87.80 | |
Providence
| Facility | $58.00 | $58.00 | $70.00 | |
United
| Professional | $96.00 | $96.00 | $96.00 |