| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,903.92 | $1,903.92 | $1,903.92 | |
Providence
| Facility | $942.49 | $1,295.92 | $1,903.92 |
Rmvl Prosth Tot Knee Prosth Mma W/Wo Insj Spacer
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,903.92 | $1,903.92 | $1,903.92 | |
Providence
| Facility | $942.49 | $1,295.92 | $1,903.92 |