| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $53.27 | $53.27 | $53.27 | |
CDPHP
| Professional | $53.27 | $53.27 | $53.27 | |
Cigna
| Professional | $1,025.28 | $1,076.03 | $1,289.21 | |
MVP Health Care
| Professional | $1,076.03 | $1,076.03 | $1,289.21 |