| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $373.70 | $373.70 | $373.70 |
Oct Skn Img Acquisj I&R Ea Addl Les
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $373.70 | $373.70 | $373.70 |