| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $25.45 | $39.22 | $39.22 |
Moderate Sedatj Same Phys/Qhp Each Addl 15 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $25.45 | $39.22 | $39.22 |