| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $766.02 | $766.02 | $766.02 | |
Medica
| Professional | $1,170.03 | $1,170.03 | $1,170.03 |
Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; bilateral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $766.02 | $766.02 | $766.02 | |
Medica
| Professional | $1,170.03 | $1,170.03 | $1,170.03 |