| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.74 | $72.37 | $82.05 | |
Christus
| Facility | $92.34 | $95.47 | $95.47 | |
Lucent Health
| Facility | $174.95 | $530.24 | $530.24 | |
Moda Health
| Facility | $82.05 | $111.91 | $178.42 | |
Providence
| Facility | $82.05 | $111.91 | $189.38 |