| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $855.38 | $855.38 | $1,069.22 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Midlands
| Professional | $1,328.42 | $1,328.42 | $1,328.42 |
Ko Single Upright Pre Ots
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $855.38 | $855.38 | $1,069.22 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Midlands
| Professional | $1,328.42 | $1,328.42 | $1,328.42 |