| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $615.90 | $615.90 | $620.20 |
Rpr Lac 2.5 Cm/< Mouth&/Ant Two-Thirds Tong
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $615.90 | $615.90 | $620.20 |