| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $630.96 | $851.14 | $1,096.48 | |
Providence
| Facility | $446.68 | $707.95 | $851.14 |
RBC deglycerolized
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $630.96 | $851.14 | $1,096.48 | |
Providence
| Facility | $446.68 | $707.95 | $851.14 |