| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $169.95 | $207.72 | $972.00 | |
Medica
| Professional | $1,381.00 | $1,381.00 | $1,381.00 |
Rad-Diag Rad Diag Imaging
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $169.95 | $207.72 | $972.00 | |
Medica
| Professional | $1,381.00 | $1,381.00 | $1,381.00 |