| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Excellus BCBS
| Professional | $142.74 | $201.26 | $356.65 | |
MVP Health Care
| Professional | $150.50 | $150.50 | $150.50 | |
Univera
| Facility | $142.79 | $142.79 | $142.79 | |
Univera
| Professional | $121.37 | $142.79 | $356.65 |