| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $63.63 | $159.16 | $271.89 | |
Anthem BCBS
| Facility | $312.29 | $391.94 | $842.53 |
Other Therapeutic Services (see also 095X, an extension of 094X)-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $63.63 | $159.16 | $271.89 | |
Anthem BCBS
| Facility | $312.29 | $391.94 | $842.53 |