| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $167.42 | $212.85 | $303.61 | |
Medica
| Professional | $648.24 | $648.24 | $648.24 |
Radj Dlvr 2 Areas 3/>Ports 1 Mlt Blks 6-1Mev
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $167.42 | $212.85 | $303.61 | |
Medica
| Professional | $648.24 | $648.24 | $648.24 |