| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,418.15 | $2,418.15 | $2,418.15 | |
Providence
| Facility | $1,192.11 | $1,625.99 | $2,418.15 |
Optx&/Rdctj Vrt Fx&/Dislc Pst 1 Vrt Sgm Cr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,418.15 | $2,418.15 | $2,418.15 | |
Providence
| Facility | $1,192.11 | $1,625.99 | $2,418.15 |