| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $100.00 | $305.18 | $499.89 | |
Medica
| Professional | $632.03 | $632.03 | $632.03 |
Dom/R-Home E/M Est Pt Mod Hi Severity 40 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $100.00 | $305.18 | $499.89 | |
Medica
| Professional | $632.03 | $632.03 | $632.03 |