| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $75.00 | $75.00 | $75.00 |
Ifxj Loclz&Trakg Trgt/Pt Mtn Dur Radtx Ea Fxj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $75.00 | $75.00 | $75.00 |