| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $26.23 | $37.17 | $59.38 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Medic-Physical Medic-Rehabilit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $26.23 | $37.17 | $59.38 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |