| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $4.34 | $283.19 | $472.93 | |
Hometown Health
| Professional | 26 | $1.00 | $57.12 | $83.86 |
Hometown Health
| Professional | TC | $3.35 | $233.52 | $389.98 |
Hometown Health
| Professional | $4.90 | $283.19 | $424.79 | |
Hometown Health
| Professional | 26 | $1.12 | $49.67 | $74.51 |
Hometown Health
| Professional | TC | $3.77 | $233.52 | $350.28 |