| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $20.09 | $108.95 | $3,971.21 |
Medical/Surgical Supplies and Devices-Sterile Supply
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $20.09 | $108.95 | $3,971.21 |