| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $122.20 | $122.20 | $133.57 |
Ifxj Loclz&Trakg Trgt/Pt Mtn Dur Radtx Ea Fxj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $122.20 | $122.20 | $133.57 |