| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,909.78 | $2,909.78 | $2,909.78 | |
Providence
| Facility | $1,799.58 | $2,568.86 | $3,353.52 |
Laps Gstr Rstcv Px W/Byp&Sm Int Rcnstj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,909.78 | $2,909.78 | $2,909.78 | |
Providence
| Facility | $1,799.58 | $2,568.86 | $3,353.52 |