| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $302.00 | $426.58 | $426.58 | |
Medica
| Professional | $524.81 | $524.81 | $524.81 |
Radj Dlvr 1 Area 1/Prll Opsd Ports Smpl 11-19Mev
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $302.00 | $426.58 | $426.58 | |
Medica
| Professional | $524.81 | $524.81 | $524.81 |