| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 |
Unlisted maxillofacial prosthetic procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 |