| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $512.86 | $512.86 | $512.86 | |
Medcost
| Facility | $109.65 | $213.80 | $467.74 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |
Radj Dlvr 3/> Areas Custom Blking 20Mev/<
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $512.86 | $512.86 | $512.86 | |
Medcost
| Facility | $109.65 | $213.80 | $467.74 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |