| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $233.52 | $265.50 | $630.50 |
N-Invas Artl Plaq Alys Data Prp Quan Review I&R
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $233.52 | $265.50 | $630.50 |