| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | $100.00 | $208.93 | $363.08 | |
Lucent Health
| Facility | $912.01 | $912.01 | $2,630.27 | |
Lucent Health
| Professional | $1,778.28 | $1,778.28 | $1,778.28 | |
United
| Professional | $331.13 | $436.52 | $691.83 |