| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $621.92 | $621.92 | $621.92 | |
Medica
| Professional | $875.23 | $875.23 | $875.23 |
Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; unilateral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $621.92 | $621.92 | $621.92 | |
Medica
| Professional | $875.23 | $875.23 | $875.23 |