| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $23,442.29 | $23,442.29 | $24,547.09 |
O.R. proc w diagnoses of other contact w health services w/o CC/MCC
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $23,442.29 | $23,442.29 | $24,547.09 |