| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,564.60 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $2,141.06 | $2,997.48 | $4,004.55 | |
Providence
| Facility | $2,141.06 | $2,997.48 | $4,004.55 |
Rescj Lip > One-Fourth W/O Rcnstj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,564.60 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $2,141.06 | $2,997.48 | $4,004.55 | |
Providence
| Facility | $2,141.06 | $2,997.48 | $4,004.55 |