| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $184.60 | $234.33 | $336.18 | |
Medica
| Professional | $720.48 | $720.48 | $720.48 |
Radj Dlvr 2 Areas 3/>Ports 1 Mlt Blks 11-19Mev
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $184.60 | $234.33 | $336.18 | |
Medica
| Professional | $720.48 | $720.48 | $720.48 |