| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,173.73 | $3,173.73 | $3,173.73 | |
Providence
| Facility | $1,565.54 | $2,146.46 | $3,173.73 |
Lam Bx/Exc Ispi Neo Idrl Xmed Lumbar
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,173.73 | $3,173.73 | $3,173.73 | |
Providence
| Facility | $1,565.54 | $2,146.46 | $3,173.73 |