| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $831.76 | $1,513.56 | $1,949.84 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj 1St Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $831.76 | $1,513.56 | $1,949.84 |