| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Well Sense
| Professional | $105.99 | $116.59 | $148.38 |
Domicil/Rest Home New Pt Hi-Mod Sever 45 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Well Sense
| Professional | $105.99 | $116.59 | $148.38 |