| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
UPMC Health Plan
| Professional | $69.12 | $69.12 | $69.12 |
Dom/R-Home E/M Est Pt Mod Hi Severity 40 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
UPMC Health Plan
| Professional | $69.12 | $69.12 | $69.12 |