| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $39.17 | $249.32 | $546.35 | |
United
| Facility | $750.00 | $750.00 | $750.00 |
Medical/Surgical Supplies & Devices - Prosthetic/Orthotic Devices
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $39.17 | $249.32 | $546.35 | |
United
| Facility | $750.00 | $750.00 | $750.00 |