| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $199.55 | $238.73 | $260.77 |
Rad-Diag Rad Diag Imaging
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $199.55 | $238.73 | $260.77 |