| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $549.54 | $741.31 | $758.58 |
Expl N/Flwd Surg Rpr W/Wo Lysis Other Artery
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $549.54 | $741.31 | $758.58 |