| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $2,089.30 | $9,332.54 | $17,782.79 | |
Molina
| Facility | $1,174.90 | $1,174.90 | $1,348.96 | |
Quartz
| Facility | $13,803.84 | $13,803.84 | $13,803.84 | |
United
| Facility | $2,089.30 | $9,332.54 | $17,782.79 |