| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,303.53 | $2,303.53 | $2,303.53 | |
Providence
| Facility | $1,139.05 | $2,624.05 | $2,746.32 |
Thorcom Ctrl Traumtc Hemrrg&/Rpr Lng Tear
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,303.53 | $2,303.53 | $2,303.53 | |
Providence
| Facility | $1,139.05 | $2,624.05 | $2,746.32 |