| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $38,499.62 | $38,499.62 | $38,499.62 | |
Medical Mutual of Ohio
| Professional | $2,415.14 | $2,415.14 | $2,472.12 |
Lam&Sctj Dentate Lig W/Wo Dural Grf Crv >2 Seg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $38,499.62 | $38,499.62 | $38,499.62 | |
Medical Mutual of Ohio
| Professional | $2,415.14 | $2,415.14 | $2,472.12 |