| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,769.47 | $1,769.47 | $1,769.47 | |
Medica
| Professional | $3,021.48 | $3,021.48 | $3,021.48 |
Tprnl Balo Cntnc Dev Bi Plmt W/Cstsc & Fluor
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,769.47 | $1,769.47 | $1,769.47 | |
Medica
| Professional | $3,021.48 | $3,021.48 | $3,021.48 |