| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Professional | $78.11 | $78.11 | $80.68 |
Dom/R-Home E/M Est Pt Self-Lmtd/Minor 15 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Professional | $78.11 | $78.11 | $80.68 |