| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,314.37 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $2,174.19 | $11,543.88 | $16,161.43 | |
Providence
| Facility | $2,174.19 | $11,543.88 | $16,161.43 |
Glssc Composit W/Rescj Floor & Mandibular Rescj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,314.37 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $2,174.19 | $11,543.88 | $16,161.43 | |
Providence
| Facility | $2,174.19 | $11,543.88 | $16,161.43 |