| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $210.21 | $283.45 | $837.14 |
Medical/Surgical Supplies & Devices - Prosthetic/Orthotic Devices
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $210.21 | $283.45 | $837.14 |