| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $256.83 | $451.71 | $484.36 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj Ea Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $256.83 | $451.71 | $484.36 |