| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $86.82 | $102.14 | $175.89 |
Indiv Phys Supvj Home/Dom/R-Home Mo 30 Min/>
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $86.82 | $102.14 | $175.89 |