| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $32.34 | $60.00 | $108.44 | |
Providence
| Facility | $55.11 | $64.84 | $74.56 | |
Providence
| Professional | $66.55 | $96.08 | $104.86 | |
United
| Professional | $82.80 | $105.58 | $145.68 |