| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $136.26 | $227.16 | $227.16 | |
Lucent Health
| Professional | $323.16 | $323.16 | $323.16 | |
Providence
| Facility | $53.00 | $53.00 | $64.00 |
Dom/R-Home E/M Est Pt Self-Lmtd/Minor 15 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $136.26 | $227.16 | $227.16 | |
Lucent Health
| Professional | $323.16 | $323.16 | $323.16 | |
Providence
| Facility | $53.00 | $53.00 | $64.00 |