| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $544.00 | $544.00 | $618.00 | |
Pacific Source
| Facility | $229.29 | $1,100.00 | $1,100.00 |
Peritoneal / Composite Or Ot
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $544.00 | $544.00 | $618.00 | |
Pacific Source
| Facility | $229.29 | $1,100.00 | $1,100.00 |