| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $190.72 | $190.72 | $198.30 |
Professional Fees (Extension of 096X and 097X)-Emergency Room
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $190.72 | $190.72 | $198.30 |