| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $955.20 | $1,017.14 | $1,592.00 | |
CareSource
| Professional | $796.00 | $796.00 | $985.05 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 | |
United
| Professional | $840.67 | $889.25 | $889.25 |