| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $91.20 | $204.17 | $630.96 | |
Medica
| Professional | $120.23 | $724.44 | $724.44 |
Radj Dlvr 2 Areas 3/>Ports 1 Mlt Blks 11-19Mev
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $91.20 | $204.17 | $630.96 | |
Medica
| Professional | $120.23 | $724.44 | $724.44 |