| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $56.65 | $64.56 | $81.28 |
Mod Sedatj Diff Phys/Qhp <5 Yrs Init 30 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $56.65 | $64.56 | $81.28 |