| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $106.94 | $106.94 | $287.79 | |
Providence
| Facility | $332.67 | $332.67 | $332.67 |
Njx Infus/Bolus Dx/Sbst Edrl/Subarach Lum/Sacral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $106.94 | $106.94 | $287.79 | |
Providence
| Facility | $332.67 | $332.67 | $332.67 |