| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $7,585.78 | $7,585.78 | $7,585.78 | |
Molina
| Professional | $58.88 | $58.88 | $58.88 | |
Quartz
| Facility | $22,908.68 | $28,183.83 | $28,183.83 | |
Quartz
| Professional | $7,585.78 | $7,585.78 | $7,585.78 |