| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,795.68 | $2,795.68 | $2,795.68 | |
Providence
| Facility | $2,795.68 | $2,795.68 | $2,795.68 |
Evasc Rpr Dplmnt Ilio-Iliac Ndgft Rpt
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,795.68 | $2,795.68 | $2,795.68 | |
Providence
| Facility | $2,795.68 | $2,795.68 | $2,795.68 |