| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Medica
| Professional | $87.00 | $98.00 | $98.00 |
Hlth&Behavior Ivntj Ea 15 Min Grp 2/>Pts
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Medica
| Professional | $87.00 | $98.00 | $98.00 |