| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $74.81 | $117.65 | $117.65 |
Moderate Sedatj Same Phys/Qhp <5 Yrs Init 30 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $74.81 | $117.65 | $117.65 |