| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $381.21 | $381.21 | $381.21 | |
Providence
| Facility | $381.21 | $381.21 | $381.21 |
Perq Prcrd Drg 6yr+ W/O Congenital Car Anomaly
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $381.21 | $381.21 | $381.21 | |
Providence
| Facility | $381.21 | $381.21 | $381.21 |