| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $630.96 | $630.96 | $630.96 | |
Medica
| Facility | $54.95 | $436.52 | $1,698.24 | |
United
| Facility | $173.78 | $416.87 | $1,778.28 |
Unlisted maxillofacial prosthetic procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $630.96 | $630.96 | $630.96 | |
Medica
| Facility | $54.95 | $436.52 | $1,698.24 | |
United
| Facility | $173.78 | $416.87 | $1,778.28 |