| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $17.59 | $245.29 | $713.47 |
Medical/Surgical Supplies & Devices - Prosthetic/Orthotic Devices
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $17.59 | $245.29 | $713.47 |