| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $44,999.55 | $44,999.55 | $44,999.55 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $44,999.55 | $44,999.55 | $44,999.55 |