| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Sentara
| Facility | $3,993.00 | $3,993.00 | $3,993.00 |
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 |
|---|---|---|---|---|---|
Sentara
| Facility | $3,993.00 | $3,993.00 | $3,993.00 |