| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $712.98 | $712.98 | $712.98 | |
Providence
| Facility | $351.23 | $439.04 | $712.98 |
Preperitoneal Pel Pack F/Hemrrg Assoc Pel Trma
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $712.98 | $712.98 | $712.98 | |
Providence
| Facility | $351.23 | $439.04 | $712.98 |