| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $57.84 | $73.26 | $125.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $57.84 | $73.26 | $125.00 |