| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $481.81 | $481.81 | $481.81 | |
Providence
| Facility | $601.23 | $601.23 | $601.23 |
Cltx Pel Ring Fx Dislc Diast/Sublxtj W/O Manj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $481.81 | $481.81 | $481.81 | |
Providence
| Facility | $601.23 | $601.23 | $601.23 |