| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CDPHP
| Facility | $616.60 | $616.60 | $616.60 | |
CDPHP
| Professional | $616.60 | $616.60 | $616.60 | |
Excellus BCBS
| Professional | $426.58 | $602.56 | $1,071.52 | |
United
| Professional | $467.74 | $489.78 | $758.58 | |
Univera
| Facility | $363.08 | $426.58 | $426.58 | |
Univera
| Professional | $257.04 | $426.58 | $1,071.52 |