| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $0.12 | $0.12 | $0.23 | |
Moda Health
| Professional | $60.26 | $60.26 | $60.26 | |
Providence
| Facility | $0.12 | $0.13 | $0.20 | |
Providence
| Professional | $0.35 | $0.35 | $60.26 |
Microcapillary tube sealant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $0.12 | $0.12 | $0.23 | |
Moda Health
| Professional | $60.26 | $60.26 | $60.26 | |
Providence
| Facility | $0.12 | $0.13 | $0.20 | |
Providence
| Professional | $0.35 | $0.35 | $60.26 |