| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $541.04 | $541.04 | $541.04 | |
Providence
| Facility | $541.04 | $680.55 | $700.18 |
Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $541.04 | $541.04 | $541.04 | |
Providence
| Facility | $541.04 | $680.55 | $700.18 |