| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $1,778.28 | $2,398.83 | $2,454.71 |
Evasc Rpr Aaa W/Unibdy Bfrc Prosth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $1,778.28 | $2,398.83 | $2,454.71 |