| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $136.49 | $136.49 | $136.49 | |
United
| Facility | $2,500.00 | $2,500.00 | $3,000.00 |
Medical/Surgical Supplies & Devices - Prosthetic/Orthotic Devices
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $136.49 | $136.49 | $136.49 | |
United
| Facility | $2,500.00 | $2,500.00 | $3,000.00 |