| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Fidelis
| Facility | $165.00 | $165.00 | $165.00 |
Anesthesia-Anesthesia Incident to Radiology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Fidelis
| Facility | $165.00 | $165.00 | $165.00 |