| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $122.51 | $122.51 | $122.51 | |
Providence
| Facility | $122.51 | $152.75 | $157.49 |
Bypass graft; composite, prosthetic and vein (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $122.51 | $122.51 | $122.51 | |
Providence
| Facility | $122.51 | $152.75 | $157.49 |