| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $263.36 | $438.93 | $438.93 | |
CDPHP
| Professional | $438.93 | $438.93 | $1,560.00 | |
Cigna
| Professional | $504.27 | $534.53 | $640.42 | |
MVP Health Care
| Facility | $13.73 | $19.91 | $254.50 | |
MVP Health Care
| Professional | $352.23 | $365.78 | $1,009.54 | |
United
| Professional | $263.36 | $462.38 | $521.45 |