| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $2,456.35 | $2,456.35 | $2,535.69 |
Evasc Rpr Aaa W/Mdlr Bfrc Prosth 2 Limbs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $2,456.35 | $2,456.35 | $2,535.69 |