| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | $223.87 | $223.87 | $223.87 | |
Medica
| Facility | $602.56 | $7,762.47 | $19,498.45 | |
Medica
| Facility | AS | $229.09 | $229.09 | $229.09 |
Medica
| Professional | $8,317.64 | $11,220.18 | $58,884.37 | |
United
| Facility | $3,162.28 | $9,120.11 | $10,715.19 | |
United
| Professional | $478.63 | $6,760.83 | $12,882.50 |