| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $358.33 | $527.59 | $1,237.82 | |
Cigna
| Facility | $620.00 | $825.00 | $1,612.00 | |
Qualchoice
| Facility | $412.08 | $678.11 | $1,675.56 | |
United
| Facility | $758.00 | $758.00 | $758.00 |