| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | $71.31 | $71.31 | $71.31 | |
Medica
| Facility | $51.98 | $248.18 | $434.12 | |
Medica
| Professional | $66.69 | $199.68 | $710.30 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | $71.31 | $71.31 | $71.31 | |
Medica
| Facility | $51.98 | $248.18 | $434.12 | |
Medica
| Professional | $66.69 | $199.68 | $710.30 |