| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $289.19 | $289.19 | $289.19 | |
Providence
| Facility | $289.19 | $289.19 | $289.19 |
Removal Perq Left Hrt Vad Artl/Artl&Ven Sep Insj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $289.19 | $289.19 | $289.19 | |
Providence
| Facility | $289.19 | $289.19 | $289.19 |