| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $100.67 | $127.06 | $176.96 |
Medic-Physical Medic-Rehabilit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $100.67 | $127.06 | $176.96 |