| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $50.12 | $1,047.13 | $4,570.88 |
Medical/Surgical Supplies and Devices - Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $50.12 | $1,047.13 | $4,570.88 |