| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,650.78 | $1,650.78 | $1,650.78 | |
Cigna
| Facility | $259.45 | $259.45 | $611.00 | |
Martin's Point
| Facility | $1,650.78 | $1,650.78 | $1,650.78 |
Rpr Lac 2.5 Cm/< Mouth&/Ant Two-Thirds Tong
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,650.78 | $1,650.78 | $1,650.78 | |
Cigna
| Facility | $259.45 | $259.45 | $611.00 | |
Martin's Point
| Facility | $1,650.78 | $1,650.78 | $1,650.78 |