| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,705.16 | $3,705.16 | $3,705.16 |
Ambulance-Air Ambulance
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,705.16 | $3,705.16 | $3,705.16 |