| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.95 | $54.95 | $17,782.79 | |
Medica
| Professional | $22,387.21 | $22,387.21 | $22,387.21 |
Lvr Altrnsplj Htrtpc Prtl/Whl Don Any Age
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.95 | $54.95 | $17,782.79 | |
Medica
| Professional | $22,387.21 | $22,387.21 | $22,387.21 |