| 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 | |
MVP Health Care
| Facility | $555.00 | $597.00 | $74,999.25 | |
United
| Professional | $699.74 | $920.64 | $1,884.07 |