| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,840.30 | $1,840.30 | $1,840.30 | |
Providence
| Facility | $1,840.30 | $2,284.75 | $2,378.19 |
Revj Fem Anast Bpg Grn Opn W/Nonautog Patch Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,840.30 | $1,840.30 | $1,840.30 | |
Providence
| Facility | $1,840.30 | $2,284.75 | $2,378.19 |