| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2,615.50 | $5,331.00 | $9,038.50 |
Rmvl Icar Ischm Mntrng Dvce
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2,615.50 | $5,331.00 | $9,038.50 |
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