| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $286.04 | $286.04 | $286.04 | |
Providence
| Facility | $286.04 | $486.85 | $500.94 |
Open Harvest Upper Extremity Art 1 Segment Cab
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $286.04 | $286.04 | $286.04 | |
Providence
| Facility | $286.04 | $486.85 | $500.94 |