| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $1.00 | $1.00 | $1.00 | |
CDPHP
| Facility | $1,350.00 | $1,350.00 | $4,050.00 | |
MVP Health Care
| Facility | $597.00 | $597.00 | $597.00 |
Unspecified Restorative Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $1.00 | $1.00 | $1.00 | |
CDPHP
| Facility | $1,350.00 | $1,350.00 | $4,050.00 | |
MVP Health Care
| Facility | $597.00 | $597.00 | $597.00 |