| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $21.88 | $21.88 | $30.90 | |
Providence
| Facility | $15.14 | $21.88 | $30.90 |
Pulp Vitality Tests
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $21.88 | $21.88 | $30.90 | |
Providence
| Facility | $15.14 | $21.88 | $30.90 |