| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $39.81 | $63.10 | $257.04 | |
Medica
| Professional | $257.04 | $257.04 | $257.04 |
Moderate Sedatj Same Phys/Qhp 5/>Yrs Init 30 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $39.81 | $63.10 | $257.04 | |
Medica
| Professional | $257.04 | $257.04 | $257.04 |