| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | QZ | $118.86 | $118.86 | $118.86 |
Anes Closed Humrl H/N Strnclav Joint& Sho Joint
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | QZ | $118.86 | $118.86 | $118.86 |