| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $409.60 | $409.60 | $409.60 | |
Providence
| Facility | $243.82 | $382.91 | $479.44 |
Splenc Tot En Bloc Extnsv Ds Conjunct W/Oth Px
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $409.60 | $409.60 | $409.60 | |
Providence
| Facility | $243.82 | $382.91 | $479.44 |