| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Moda Health
| Facility | $1.12 | $4.95 | $23.38 | |
Oscar Health
| Facility | $402.03 | $1,453.03 | $3,730.00 | |
Providence
| Facility | $0.02 | $0.02 | $0.02 |