| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $446.68 | $446.68 | $446.68 | |
United
| Facility | $457.09 | $1,819.70 | $2,041.74 |
Unlisted maxillofacial prosthetic procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $446.68 | $446.68 | $446.68 | |
United
| Facility | $457.09 | $1,819.70 | $2,041.74 |