| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $15.25 | $105.19 | $616.34 |
Medical/Surgical Supplies and Devices - Sterile Supply
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $15.25 | $105.19 | $616.34 |