| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $100.00 | $100.00 | $5,623.41 |
Other Antepartum Diagnoses W O Medical Complications
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $100.00 | $100.00 | $5,623.41 |