| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $893.86 | $893.86 | $893.86 |
Unspecified maxillofacial prosthesis, by report, provided by a nonphysician
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $893.86 | $893.86 | $893.86 |