| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $249.49 | $249.49 | $404.22 |
Perm Flp Tub Occls W/Implant Transcrv Approach
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $249.49 | $249.49 | $404.22 |