| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $39.68 | $50.87 | $78.75 | |
Providence
| Professional | $25.75 | $68.84 | $68.84 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $39.68 | $50.87 | $78.75 | |
Providence
| Professional | $25.75 | $68.84 | $68.84 |