| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $274.39 | $406.98 | $573.85 | |
Medica
| Facility | $342.16 | $342.16 | $342.16 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj Ea Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $274.39 | $406.98 | $573.85 | |
Medica
| Facility | $342.16 | $342.16 | $342.16 |