| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $79.50 | $79.50 | $95.25 | |
Lucent Health
| Facility | $100.00 | $120.00 | $200.00 | |
Lucent Health
| Professional | $165.00 | $165.00 | $165.00 | |
Moda Health
| Facility | $139.37 | $190.00 | $317.05 | |
Moda Health
| Professional | $18.00 | $73.13 | $140.00 | |
Oscar Health
| Facility | $23.36 | $31.60 | $169.88 | |
Providence
| Professional | $110.00 | $110.00 | $125.00 |