| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,275.00 | $1,275.00 | $3,239.00 |
Rmvl I-Aort Balo Asst Dev W/Rpr Fem Art W/Wo Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,275.00 | $1,275.00 | $3,239.00 |