| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $14.58 | $14.58 | $71.17 | |
Qualchoice
| Facility | $16.77 | $16.77 | $31.89 |
Medical/Surgical Supplies and Devices - Other Supplies/Devices
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $14.58 | $14.58 | $71.17 | |
Qualchoice
| Facility | $16.77 | $16.77 | $31.89 |