| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $186.43 | $186.43 | $223.36 | |
Pacific Source
| Facility | $4,296.88 | $6,071.55 | $7,230.38 |
Tprnl Balo Cntnc Dev Uni Plmt W/Cstsc & Fluor
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $186.43 | $186.43 | $223.36 | |
Pacific Source
| Facility | $4,296.88 | $6,071.55 | $7,230.38 |