| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $5.00 | $5.00 | $5.50 | |
CDPHP
| Professional | $5.00 | $5.00 | $5.00 | |
MVP Health Care
| Facility | $555.00 | $597.00 | $74,999.25 | |
Univera
| Facility | $12.75 | $12.75 | $12.75 | |
Univera
| Professional | $12.75 | $12.75 | $13.96 |