| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $1,258.93 | $1,698.24 | $1,778.28 |
Evasc Rpr Iliac Art Ilio-Iliac Prosthesis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $1,258.93 | $1,698.24 | $1,778.28 |