| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $31.81 | $45.37 | $358.28 | |
Medica
| Professional | $246.00 | $246.00 | $246.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $31.81 | $45.37 | $358.28 | |
Medica
| Professional | $246.00 | $246.00 | $246.00 |