| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $31.43 | $57.38 | $180.00 | |
Medica
| Professional | $192.26 | $192.26 | $192.26 |
Medic-Physical Medic-Rehabilit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $31.43 | $57.38 | $180.00 | |
Medica
| Professional | $192.26 | $192.26 | $192.26 |