| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $434.18 | $434.18 | $699.00 |
Bkbench Rcnstj Lvr Grf Artl Anast Ea
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $434.18 | $434.18 | $699.00 |