| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $4,126.96 | $5,000.00 | $5,242.08 | |
Medica
| Professional | $11,402.46 | $11,402.46 | $11,402.46 |
Lam&Sctj Dentate Lig W/Wo Dural Grf Crv >2 Seg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $4,126.96 | $5,000.00 | $5,242.08 | |
Medica
| Professional | $11,402.46 | $11,402.46 | $11,402.46 |