| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $181.97 | $251.19 | $331.13 | |
United
| Professional | $100.00 | $100.00 | $141.25 |
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 |
|---|---|---|---|---|---|
Pacific Source
| Facility | $181.97 | $251.19 | $331.13 | |
United
| Professional | $100.00 | $100.00 | $141.25 |