| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1,860.00 | $2,146.00 | $3,929.00 | |
Hally Health
| Facility | $100.00 | $125.00 | $550.00 |
Other Therapeutic Services (also See 095X, an extension of 094X) - Complex Medical Equipment Routine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1,860.00 | $2,146.00 | $3,929.00 | |
Hally Health
| Facility | $100.00 | $125.00 | $550.00 |