| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $6,934.00 | $6,934.00 | $26,502.00 |
Laps Gstr Rstcv Px W/Byp&Sm Int Rcnstj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $6,934.00 | $6,934.00 | $26,502.00 |