| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $3,763.66 | $4,870.85 | $5,000.00 | |
Medica
| Professional | $10,396.14 | $10,396.14 | $10,396.14 |
Lam&Sctj Dentate Lig W/Wo Dural Grf Crv 1/2 Seg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $3,763.66 | $4,870.85 | $5,000.00 | |
Medica
| Professional | $10,396.14 | $10,396.14 | $10,396.14 |