| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,419.21 | $2,419.21 | $2,419.21 | |
Providence
| Facility | $1,191.46 | $2,546.05 | $2,731.77 |
Strtctc Impltj Nstim Eltrd W/O Record 1st Array
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,419.21 | $2,419.21 | $2,419.21 | |
Providence
| Facility | $1,191.46 | $2,546.05 | $2,731.77 |