| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2,630.27 | $4,570.88 | $11,748.98 | |
BCBS
| Professional | $95.50 | $95.50 | $95.50 |
Unspecified Restorative Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2,630.27 | $4,570.88 | $11,748.98 | |
BCBS
| Professional | $95.50 | $95.50 | $95.50 |