| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $724.44 | $977.24 | $1,023.29 |
Expl N/Flwd Surg Rpr W/Wo Lysis Popliteal Artery
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $724.44 | $977.24 | $1,023.29 |