| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | $162.18 | $162.18 | $162.18 | |
Medica
| Facility | $54.95 | $1,737.80 | $9,549.93 | |
Medica
| Professional | $1,023.29 | $1,584.89 | $6,025.60 | |
United
| Facility | $2,818.38 | $5,754.40 | $6,918.31 | |
United
| Professional | $229.09 | $891.25 | $1,737.80 |