| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $3,002.00 | $7,041.50 | $11,042.50 |
Icar Ischm Mntrng Sys Eltrd
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $3,002.00 | $7,041.50 | $11,042.50 |
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