| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $107.15 | $107.15 | $107.15 | |
Christus
| Facility | $12.02 | $16.98 | $32.36 | |
Cigna
| Facility | $1,096.48 | $1,096.48 | $1,122.02 | |
Oscar Health
| Facility | $144.54 | $575.44 | $588.84 | |
Providence
| Facility | $1,122.02 | $1,122.02 | $1,122.02 |