| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 |
Unspecified Orthodontic Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 |