| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | $457.09 | $457.09 | $457.09 | |
Ambetter
| Professional | 50 | $660.69 | $660.69 | $660.69 |
Medica
| Facility | $575.44 | $5,495.41 | $19,498.45 | |
Medica
| Facility | AS | $218.78 | $218.78 | $218.78 |
Medica
| Professional | $3,235.94 | $5,128.61 | $22,908.68 | |
United
| Facility | $3,162.28 | $9,120.11 | $10,715.19 | |
United
| Professional | $446.68 | $2,818.38 | $6,165.95 |