| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $0.78 | $2.57 | $93.33 |
Pharmacy - Drugs Incident to Radiology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $0.78 | $2.57 | $93.33 |