| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $265.02 | $265.02 | $266.68 |
Teletherapy Isodose Plan Complete
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $265.02 | $265.02 | $266.68 |