| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $487.94 | $487.94 | $487.94 | |
Providence
| Facility | $487.94 | $612.95 | $631.24 |
Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $487.94 | $487.94 | $487.94 | |
Providence
| Facility | $487.94 | $612.95 | $631.24 |