| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $90.00 | $90.00 | $630.00 | |
Lucent Health
| Professional | $204.00 | $258.39 | $264.18 | |
Moda Health
| Professional | $45.34 | $66.00 | $152.52 | |
Oscar Health
| Professional | $55.40 | $83.50 | $117.60 | |
Providence
| Facility | $25.00 | $25.00 | $35.00 | |
Providence
| Professional | $30.00 | $35.00 | $35.00 |