| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $151.16 | $151.16 | $151.16 | |
Medica
| Professional | $236.16 | $236.16 | $236.16 |
Macr Exm Diss&Prp Nonmicr Imprnt/Conslt/Frz Se
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $151.16 | $151.16 | $151.16 | |
Medica
| Professional | $236.16 | $236.16 | $236.16 |