| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $55.00 | $1,300.00 | $1,300.00 | |
Lucent Health
| Professional | $2,154.00 | $2,154.00 | $2,154.00 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj Ea Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $55.00 | $1,300.00 | $1,300.00 | |
Lucent Health
| Professional | $2,154.00 | $2,154.00 | $2,154.00 |