| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $243.27 | $382.50 | $1,159.92 |
Indiv Phys Supvj Home/Dom/R-Home Mo 30 Min/>
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $243.27 | $382.50 | $1,159.92 |