| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,330.80 | $1,330.80 | $1,330.80 | |
Providence
| Facility | $661.53 | $909.60 | $1,436.21 |
Ostc Compl All Metar Heads W/Prtl Prox Phalangc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,330.80 | $1,330.80 | $1,330.80 | |
Providence
| Facility | $661.53 | $909.60 | $1,436.21 |