| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $1,330.55 | $1,330.55 | $1,377.59 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj 1St Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $1,330.55 | $1,330.55 | $1,377.59 |