| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $450.91 | $450.91 | $450.91 | |
CDPHP
| Professional | $329.16 | $450.91 | $450.91 | |
Cigna
| Professional | $549.41 | $549.41 | $658.26 | |
MVP Health Care
| Professional | $293.08 | $338.18 | $1,015.00 |