| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $637.88 | $2,754.60 | $24,479.14 | |
United
| Facility | $5,000.00 | $5,000.00 | $5,000.00 |
Medical/Surgical Supplies and Devices-Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $637.88 | $2,754.60 | $24,479.14 | |
United
| Facility | $5,000.00 | $5,000.00 | $5,000.00 |