| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $822.37 | $988.26 | $1,421.93 | |
Medcost
| Professional | $880.00 | $969.94 | $1,474.75 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj 1St Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $822.37 | $988.26 | $1,421.93 | |
Medcost
| Professional | $880.00 | $969.94 | $1,474.75 |