| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,778.42 | $5,778.42 | $5,778.42 | |
Florida Blue
| Professional | $445.00 | $445.00 | $445.00 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 |
Unspecified Restorative Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,778.42 | $5,778.42 | $5,778.42 | |
Florida Blue
| Professional | $445.00 | $445.00 | $445.00 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 |