| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $239.88 | $323.59 | $446.68 | |
United
| Professional | $154.88 | $177.83 | $186.21 |
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 |
|---|---|---|---|---|---|
Pacific Source
| Facility | $239.88 | $323.59 | $446.68 | |
United
| Professional | $154.88 | $177.83 | $186.21 |