| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,169.00 | $1,169.00 | $2,520.00 |
Leave Of Absence - Patient Convenience
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,169.00 | $1,169.00 | $2,520.00 |