| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $76.48 | $1,320.80 | $3,163.50 | |
United
| Facility | $2,500.00 | $2,500.00 | $3,000.00 |
Medical/Surgical Supplies and Devices - Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $76.48 | $1,320.80 | $3,163.50 | |
United
| Facility | $2,500.00 | $2,500.00 | $3,000.00 |