| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $9.12 | $28.18 | $95.50 | |
Qualchoice
| Facility | $10.72 | $31.62 | $109.65 |
Medical/Surgical Supplies and Devices-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $9.12 | $28.18 | $95.50 | |
Qualchoice
| Facility | $10.72 | $31.62 | $109.65 |