| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $331.67 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $339.66 | $339.66 | $339.66 |
Hyaluronan or derivative, Visco-3, for intra-articular injection, per dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $331.67 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $339.66 | $339.66 | $339.66 |