| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $3,970.00 | $10,000.00 | $10,000.00 | |
Providence
| Facility | $14,957.00 | $14,957.00 | $15,555.00 |
Loa - Reserved
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $3,970.00 | $10,000.00 | $10,000.00 | |
Providence
| Facility | $14,957.00 | $14,957.00 | $15,555.00 |