| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $1.00 | $1.00 | $1.00 | |
CareSource
| Facility | $11,121.65 | $11,121.65 | $15,218.78 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |
Unspecified Periodontal Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $1.00 | $1.00 | $1.00 | |
CareSource
| Facility | $11,121.65 | $11,121.65 | $15,218.78 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |