| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $129.35 | $129.35 | $132.83 |
Plmt Xtn Prosth Evasc Rpr Infrarenal Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $129.35 | $129.35 | $132.83 |