| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $725.78 | $953.48 | $1,033.61 |
Expl N/Flwd Surg Rpr W/Wo Lysis Popliteal Artery
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $725.78 | $953.48 | $1,033.61 |