| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | AA | $140.35 | $140.35 | $140.35 |
Ambetter
| Professional | QY | $50.13 | $50.13 | $50.13 |
Anes Perq Img Dstrj Px Nulyt Agt Spi/Sp Crv/Thrc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Professional | AA | $140.35 | $140.35 | $140.35 |
Ambetter
| Professional | QY | $50.13 | $50.13 | $50.13 |