| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $114.43 | $114.43 | $114.43 | |
CDPHP
| Professional | $83.53 | $114.43 | $114.43 | |
Cigna
| Professional | $126.75 | $126.75 | $158.44 | |
MVP Health Care
| Professional | $126.75 | $126.75 | $158.44 |