| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $642.86 | $756.30 | $1,158.93 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj 1St Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $642.86 | $756.30 | $1,158.93 |