| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,696.76 | $1,696.76 | $1,696.76 | |
Providence
| Facility | $835.02 | $1,091.36 | $1,696.76 |
Prtl Exc Vrt Bdy B1y Les W/O Spi Cord 1 Sgm Crv
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,696.76 | $1,696.76 | $1,696.76 | |
Providence
| Facility | $835.02 | $1,091.36 | $1,696.76 |