| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $3,644.37 | $3,644.37 | $3,644.37 | |
BCBS
| Professional | $2,599.00 | $2,599.00 | $2,599.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Professional | $851.39 | $1,272.35 | $2,587.89 |