| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $55.60 | $55.60 | $55.60 | |
CDPHP
| Professional | $55.60 | $55.60 | $55.60 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $55.60 | $55.60 | $55.60 | |
CDPHP
| Professional | $55.60 | $55.60 | $55.60 |