| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $11,429.07 | $11,429.07 | $11,429.07 | |
Midlands
| Professional | $10,808.92 | $10,808.92 | $10,808.92 | |
Wellmark
| Professional | $9,000.00 | $9,000.00 | $9,000.00 |
Unspecified Orthodontic Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $11,429.07 | $11,429.07 | $11,429.07 | |
Midlands
| Professional | $10,808.92 | $10,808.92 | $10,808.92 | |
Wellmark
| Professional | $9,000.00 | $9,000.00 | $9,000.00 |