| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $316.01 | $316.01 | $316.01 | |
Providence
| Facility | $316.01 | $640.90 | $660.33 |
Opn Fem Art Expos Dlvr Evasc Prosth Uni
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $316.01 | $316.01 | $316.01 | |
Providence
| Facility | $316.01 | $640.90 | $660.33 |