| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $30.20 | $30.20 | $31.62 | |
CDPHP
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $29.51 | $29.51 | $29.51 | |
Univera
| Facility | $15.85 | $15.85 | $15.85 | |
Univera
| Professional | $12.88 | $15.85 | $31.62 |