| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $327.00 | $327.00 | $409.00 | |
Excellus BCBS
| Facility | $77.91 | $77.91 | $136.11 | |
Fidelis
| Facility | $204.84 | $303.48 | $353.22 | |
MVP Health Care
| Facility | $475.00 | $475.00 | $475.00 | |
Univera
| Facility | $77.91 | $77.91 | $136.11 |