| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $30.00 | $55.00 | |
United
| Facility | $300.00 | $1,418.00 | $2,029.00 |
Unlisted Maxillofacial Prosthetic Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $30.00 | $55.00 | |
United
| Facility | $300.00 | $1,418.00 | $2,029.00 |