| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.95 | $309.03 | $1,288.25 | |
Medica
| Professional | $2,137.96 | $2,137.96 | $2,137.96 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj Ea Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.95 | $309.03 | $1,288.25 | |
Medica
| Professional | $2,137.96 | $2,137.96 | $2,137.96 |