| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.76 | $25.76 | $32.44 | |
Medcost
| Facility | $25.76 | $40.61 | $50.42 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Diagnostic Casts
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.76 | $25.76 | $32.44 | |
Medcost
| Facility | $25.76 | $40.61 | $50.42 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |