| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $164.00 | $204.00 | $222.00 |
Radj Dlvr 1 Area 1/Prll Opsd Ports Smpl 11-19Mev
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $164.00 | $204.00 | $222.00 |