| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.74 | $1,083.00 | $3,109.00 | |
BCBS
| Facility | $384.00 | $384.00 | $437.76 | |
Cigna
| Facility | $116.28 | $490.00 | $515.00 | |
United
| Facility | $95.00 | $261.00 | $721.00 |
Rpr Lac 2.5 Cm/< Mouth&/Ant Two-Thirds Tong
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.74 | $1,083.00 | $3,109.00 | |
BCBS
| Facility | $384.00 | $384.00 | $437.76 | |
Cigna
| Facility | $116.28 | $490.00 | $515.00 | |
United
| Facility | $95.00 | $261.00 | $721.00 |