| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $231.81 | $231.81 | $231.81 | |
Molina
| Facility | $1,141.00 | $1,677.00 | $5,513.00 |
Professional Fees (Extension of 096X and 097X)-Emergency Room
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $231.81 | $231.81 | $231.81 | |
Molina
| Facility | $1,141.00 | $1,677.00 | $5,513.00 |