| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $3,335.23 | $3,335.23 | $3,335.23 |
Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $3,335.23 | $3,335.23 | $3,335.23 |