| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $157.83 | $328.13 | $813.26 | |
Health Alliance Plan
| Facility | $688.00 | $688.00 | $688.00 |
Specialty Services-Treatment Room
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $157.83 | $328.13 | $813.26 | |
Health Alliance Plan
| Facility | $688.00 | $688.00 | $688.00 |