| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $145.12 | $145.12 | $179.40 |
Providence
| Facility | 26 | $145.12 | $145.12 | $179.40 |
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $145.12 | $145.12 | $179.40 |
Providence
| Facility | 26 | $145.12 | $145.12 | $179.40 |