| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Premera BCBS
| Professional | $10,000.00 | $10,000.00 | $10,000.00 | |
Providence
| Professional | $10,000.00 | $10,000.00 | $2,250,000.00 |
Unspecified Orthodontic Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Premera BCBS
| Professional | $10,000.00 | $10,000.00 | $10,000.00 | |
Providence
| Professional | $10,000.00 | $10,000.00 | $2,250,000.00 |