| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,480.00 | $2,480.00 | $2,480.00 | |
Medica
| Facility | $100.00 | $2,480.00 | $4,191.20 |
Restorigin, 1 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,480.00 | $2,480.00 | $2,480.00 | |
Medica
| Facility | $100.00 | $2,480.00 | $4,191.20 |