| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Professional | $511.44 | $552.36 | $1,611.36 |
Plmt Prox Xtn Prosth Evasc Rpr Dta Ea Prox Xtn
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Professional | $511.44 | $552.36 | $1,611.36 |