| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,659.80 | $4,659.80 | $4,659.80 | |
Cigna
| Facility | $456.00 | $456.00 | $574.02 | |
Martin's Point
| Facility | $4,659.80 | $4,659.80 | $4,659.80 |
Xtroral I&D Absc Cst/Hmtma Floor Mouth Submndb
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,659.80 | $4,659.80 | $4,659.80 | |
Cigna
| Facility | $456.00 | $456.00 | $574.02 | |
Martin's Point
| Facility | $4,659.80 | $4,659.80 | $4,659.80 |