| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.53 | $32.94 | $51.81 | |
Medica
| Facility | $25.53 | $37.27 | $87.70 | |
Medica
| Professional | $221.34 | $221.34 | $221.34 |
Diagnostic Casts
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.53 | $32.94 | $51.81 | |
Medica
| Facility | $25.53 | $37.27 | $87.70 | |
Medica
| Professional | $221.34 | $221.34 | $221.34 |