| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $82.86 | $82.86 | $82.86 | |
Providence
| Facility | $82.86 | $82.86 | $86.57 |
Ifxj Loclz&Trakg Trgt/Pt Mtn Dur Radtx Ea Fxj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $82.86 | $82.86 | $82.86 | |
Providence
| Facility | $82.86 | $82.86 | $86.57 |