| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
AmeriHealth
| Facility | $9.18 | $31.63 | $4,562.80 |
Medical/Surgical Supplies and Devices - Non Sterile Supply
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
AmeriHealth
| Facility | $9.18 | $31.63 | $4,562.80 |