| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $506.00 | $850.00 | $2,204.00 |
Leave Of Absence - Patient Convenience
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $506.00 | $850.00 | $2,204.00 |