| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $905.26 | $905.26 | $989.49 |
Ant Segment Insertion Drainage W/O Reservoir Int
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $905.26 | $905.26 | $989.49 |