| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1,023.29 | $1,949.84 | $3,890.45 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |
Unspecified Restorative Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1,023.29 | $1,949.84 | $3,890.45 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |