| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $14.77 | $14.77 | $14.77 | |
BCBS
| Facility | $425.00 | $425.00 | $425.00 | |
Molina
| Facility | $2,522.00 | $2,522.00 | $2,522.00 |
Professional Fees (Extension of 096X and 097X)-Emergency Room
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $14.77 | $14.77 | $14.77 | |
BCBS
| Facility | $425.00 | $425.00 | $425.00 | |
Molina
| Facility | $2,522.00 | $2,522.00 | $2,522.00 |