| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $13.73 | $13.73 | $13.73 |
Ambulance-Medical Transport
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $13.73 | $13.73 | $13.73 |