| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $66.06 | $85.16 | $148.01 | |
Providence
| Facility | $66.06 | $85.16 | $148.01 |
Medic-Physical Medic-Rehabilit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $66.06 | $85.16 | $148.01 | |
Providence
| Facility | $66.06 | $85.16 | $148.01 |