| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareFirst
| Professional | $2,141.00 | $2,141.00 | $2,141.00 |
Unlisted Procedure Vestibule Mouth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareFirst
| Professional | $2,141.00 | $2,141.00 | $2,141.00 |