| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,175.69 | $1,175.69 | $1,175.69 | |
Providence
| Facility | $574.50 | $789.94 | $1,175.69 |
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| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,175.69 | $1,175.69 | $1,175.69 | |
Providence
| Facility | $574.50 | $789.94 | $1,175.69 |