| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $7.26 | $12.10 | $13.21 | |
Qualchoice
| Facility | $8.28 | $10.98 | $14.48 |
Medical/Surgical Supplies Extension of 027X-Supplies Incident to Other DX Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $7.26 | $12.10 | $13.21 | |
Qualchoice
| Facility | $8.28 | $10.98 | $14.48 |