| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $32.34 | $60.00 | $85.00 | |
Providence
| Facility | $42.68 | $50.21 | $57.74 | |
Providence
| Professional | $27.71 | $39.08 | $49.54 | |
United
| Professional | $59.50 | $86.70 | $119.63 |