| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $22.04 | $22.25 | $48.78 |
Macr Exm Diss&Prp Nonmicr Imprnt/Conslt/Frz Se
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $22.04 | $22.25 | $48.78 |