| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $69,999.30 | $69,999.30 | $69,999.30 |
Hyaluronan or derivative, Visco-3, for intra-articular injection, per dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $69,999.30 | $69,999.30 | $69,999.30 |