| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.67 | $2,744.00 | $4,626.00 | |
Regence BlueShield
| Facility | $539.07 | $755.46 | $1,100.93 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |
Rpr Lac 2.5 Cm/< Mouth&/Ant Two-Thirds Tong
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.67 | $2,744.00 | $4,626.00 | |
Regence BlueShield
| Facility | $539.07 | $755.46 | $1,100.93 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |