| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
DeanCare
| Facility | $64.57 | $64.57 | $72.44 | |
Medica
| Facility | $64.57 | $64.57 | $89.13 | |
Quartz
| Facility | $114.82 | $114.82 | $177.83 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
DeanCare
| Facility | $64.57 | $64.57 | $72.44 | |
Medica
| Facility | $64.57 | $64.57 | $89.13 | |
Quartz
| Facility | $114.82 | $114.82 | $177.83 |