| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $8.28 | $44.03 | $202.78 |
Medical/Surgical Supplies and Devices - Non Sterile Supply
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $8.28 | $44.03 | $202.78 |