| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $278.00 | $721.10 | $721.10 | |
Qualchoice
| Facility | $319.70 | $319.70 | $677.83 |
Other Imaging Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $278.00 | $721.10 | $721.10 | |
Qualchoice
| Facility | $319.70 | $319.70 | $677.83 |