| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $305.18 | $499.89 | $499.89 | |
Lucent Health
| Professional | $632.03 | $632.03 | $632.03 | |
Providence
| Facility | $69.00 | $69.00 | $100.00 |
Dom/R-Home E/M Est Pt Mod Hi Severity 40 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $305.18 | $499.89 | $499.89 | |
Lucent Health
| Professional | $632.03 | $632.03 | $632.03 | |
Providence
| Facility | $69.00 | $69.00 | $100.00 |