| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $2,682.23 | $2,682.23 | $2,682.23 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |
Upper Extremi Prosthes, Not Otherwise Specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $2,682.23 | $2,682.23 | $2,682.23 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |