| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.30 | $114.09 | $194.00 | |
CareSource
| Facility | $32.21 | $33.89 | $42.11 | |
Cigna
| Facility | $54.34 | $54.34 | $54.34 | |
United
| Facility | $460.00 | $460.00 | $460.00 |
Closed Tx Temporomandibular Dislocation 1st/Sbsq
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.30 | $114.09 | $194.00 | |
CareSource
| Facility | $32.21 | $33.89 | $42.11 | |
Cigna
| Facility | $54.34 | $54.34 | $54.34 | |
United
| Facility | $460.00 | $460.00 | $460.00 |