| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $886.85 | $886.85 | $1,058.94 |
Outpatient Special Residence Charges-Hospital Owned
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $886.85 | $886.85 | $1,058.94 |
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