| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $176.19 | $176.19 | $176.19 | |
CDPHP
| Professional | $128.62 | $176.19 | $176.19 | |
Cigna
| Professional | $206.70 | $206.70 | $247.65 | |
MVP Health Care
| Professional | $206.70 | $206.70 | $247.65 |