| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $80.00 | $85.00 | $85.00 | |
Providence
| Facility | $0.03 | $0.03 | $0.03 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $80.00 | $85.00 | $85.00 | |
Providence
| Facility | $0.03 | $0.03 | $0.03 |