| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $5.70 | $5.70 | $5.99 | |
CDPHP
| Professional | $5.70 | $5.70 | $5.70 | |
MVP Health Care
| Professional | $2.00 | $2.00 | $9.31 | |
Univera
| Facility | $3.60 | $3.60 | $3.60 | |
Univera
| Professional | $3.60 | $3.60 | $3.70 |