| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $1,025.05 | $1,025.05 | $1,025.05 | |
CDPHP
| Professional | $1,025.05 | $1,025.05 | $1,025.05 | |
Excellus BCBS
| Professional | $711.86 | $1,003.72 | $1,775.51 | |
Univera
| Facility | $711.72 | $711.72 | $711.72 | |
Univera
| Professional | $604.96 | $711.72 | $1,775.51 |