| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $0.78 | $43.14 | $1,336.09 |
Special Charges - General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $0.78 | $43.14 | $1,336.09 |