| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Wellcare
| Facility | $175.01 | $305.18 | $499.89 |
Dom/R-Home E/M Est Pt Mod Hi Severity 40 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Wellcare
| Facility | $175.01 | $305.18 | $499.89 |