| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $900.00 | $900.00 | $900.00 | |
Medica
| Facility | $89.00 | $610.00 | $1,676.40 | |
United
| Facility | $139.00 | $610.00 | $1,883.00 |
Unlisted Maxillofacial Prosthetic Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $900.00 | $900.00 | $900.00 | |
Medica
| Facility | $89.00 | $610.00 | $1,676.40 | |
United
| Facility | $139.00 | $610.00 | $1,883.00 |