| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $497.44 | $497.44 | $522.30 | |
CDPHP
| Professional | $497.44 | $497.44 | $497.44 | |
Cigna
| Professional | $503.50 | $543.78 | $651.51 | |
MVP Health Care
| Professional | $503.50 | $543.78 | $651.51 |