| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $254.36 | $322.92 | $351.75 |
Domicil/Rest Home New Pt Visit Hi Sever 60 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $254.36 | $322.92 | $351.75 |