| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Professional | $2,334.50 | $2,334.50 | $2,334.50 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Professional | $2,334.50 | $2,334.50 | $2,334.50 |