| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $0.80 | $0.80 | $0.80 | |
Lucent Health
| Facility | $64.00 | $100.00 | $149.05 | |
Lucent Health
| Professional | $149.05 | $149.05 | $149.05 |
Unlisted Procedure For Miscellaneous Prosthetic Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $0.80 | $0.80 | $0.80 | |
Lucent Health
| Facility | $64.00 | $100.00 | $149.05 | |
Lucent Health
| Professional | $149.05 | $149.05 | $149.05 |