| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | 26 | $19.05 | $19.05 | $19.50 |
United
| Professional | $60.26 | $91.20 | $154.88 | |
United
| Professional | 26 | $15.85 | $20.89 | $30.20 |
United
| Professional | TC | $43.65 | $66.07 | $117.49 |