| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $167.54 | $167.54 | $424.02 | |
Medica
| Professional | $525.55 | $525.55 | $525.55 |
Radj Dlvr 1 Area 1/Prll Opsd Ports Smpl 11-19Mev
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $167.54 | $167.54 | $424.02 | |
Medica
| Professional | $525.55 | $525.55 | $525.55 |