| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $399.60 | $399.60 | $399.60 |
Hyaluronan or derivative, Visco-3, for intra-articular injection, per dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $399.60 | $399.60 | $399.60 |