| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $255.54 | $255.54 | $255.54 | |
Providence
| Facility | $255.54 | $255.54 | $255.54 |
Repositioning Perq R/L Vad W/Img Gdn Sep Insj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $255.54 | $255.54 | $255.54 | |
Providence
| Facility | $255.54 | $255.54 | $255.54 |