| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $0.04 | $0.06 | $2,400,000.00 | |
Providence
| Professional | $0.04 | $0.04 | $0.04 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $0.04 | $0.06 | $2,400,000.00 | |
Providence
| Professional | $0.04 | $0.04 | $0.04 |