| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $313.50 | $535.26 | $535.26 | |
Lucent Health
| Professional | $649.25 | $649.25 | $649.25 | |
Providence
| Facility | $69.00 | $100.00 | $100.00 |
Domicil/Rest Home New Pt Hi-Mod Sever 45 Minutes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $313.50 | $535.26 | $535.26 | |
Lucent Health
| Professional | $649.25 | $649.25 | $649.25 | |
Providence
| Facility | $69.00 | $100.00 | $100.00 |