| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Professional | $2,250,000.00 | $2,250,000.00 | $2,250,000.00 |
Unspecified Restorative Procedure By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Professional | $2,250,000.00 | $2,250,000.00 | $2,250,000.00 |