| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $742.22 | $4,387.00 | $8,344.00 | |
Regence BlueShield
| Facility | $3,310.39 | $4,430.70 | $6,456.79 | |
United
| Facility | $1,981.00 | $3,613.00 | $7,048.00 |
Conjunctpl Cul-De-Sac W/Buccal Muc Memb Graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $742.22 | $4,387.00 | $8,344.00 | |
Regence BlueShield
| Facility | $3,310.39 | $4,430.70 | $6,456.79 | |
United
| Facility | $1,981.00 | $3,613.00 | $7,048.00 |