| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $3,788.22 | $3,788.22 | $3,977.63 | |
CDPHP
| Professional | $3,788.22 | $3,788.22 | $3,788.22 | |
Univera
| Facility | $2,579.91 | $2,579.91 | $2,579.91 | |
Univera
| Professional | $2,579.91 | $2,579.91 | $3,041.01 |