| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,700.00 | $1,700.00 | $1,700.00 | |
Providence
| Facility | $1,700.00 | $1,700.00 | $1,700.00 | |
United
| Facility | $653.00 | $1,205.00 | $2,780.00 |
Leave Of Absence - Patient Convenience
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,700.00 | $1,700.00 | $1,700.00 | |
Providence
| Facility | $1,700.00 | $1,700.00 | $1,700.00 | |
United
| Facility | $653.00 | $1,205.00 | $2,780.00 |