| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $165.96 | $2,454.71 | $41,686.94 | |
CareSource
| Professional | $218.78 | $2,754.23 | $4,897.79 | |
United
| Facility | $199.53 | $199.53 | $199.53 | |
United
| Professional | $144.54 | $194.98 | $316.23 |