| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $40.00 | $144.50 | $261.25 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |
Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $40.00 | $144.50 | $261.25 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |